Myxedema coma is associated with decreased mental status and hyponatremia among patients with diagnosed or undiagnosed hypothyroidism. The diagnosis is challenging in the absence of universally accepted diagnostic criteria, but should be considered as a differential even in cases with competing established diagnoses. All patients should receive intensive care level treatment. Even with optimal treatment, mortality is very high.
Myxedema ; Coma

Graves' disease is an autoimmune disorder of the thyroid gland and the most common cause of hyperthyroidism. Classic clinical findings include ophthalmopathy (exophthalmos), dermopathy (pretibial myxedema) and thyroid acropachy. The triad of Graves' clinical findings occurs in less than 1% of Graves' patients. We present a case of Graves' disease with the clinical triad of exophthalmos, pretibial myxedema, and thyroid acropachy.
Exophthalmos ; Graves Disease ; Humans ; Hyperthyroidism ; Myxedema ; Thyroid Gland

Myxedema coma is the most extreme form of hypothyroidism and manifests as central nervous system dysfunction, defective thermoregulation, and cardiopulmonary decompensation. The curative treatment is based on the administration of thyroid hormones, but the dose and route of administration remain controversial. Here, we report a case of myxedema coma that was treated successfully with a large oral dose of levothyroxine
Body Temperature Regulation ; Central Nervous System ; Coma ; Hypothyroidism ; Myxedema ; Thyroid Hormones ; Thyroxine

Pretibial myxedema (PTM) is a asymptomatic localized thickening of the pretibial skin due to deposition of acid mucopolysacharides (glycosaminoglycans). PTM, Graves' ophthalmopathy (GO) and thyroid acropachy are the triad of classic extrathyroidal manifestations of Graves' disease. PTM usually follows the onset of GO, and PTM develops after the diagnosis and treatment of hyperthyroidism. We report here on a 51-year-old female who presented with painful, well demarcated hyperpigmented plaques with nonpitting edema on both lower legs. The histopathologic findings showed an increased accumulation of mucin throughout dermis. In our patient, PTM was the earliest manifestation and this led to the diagnosis of Graves' disease.
Dermis ; Edema ; Female ; Graves Disease ; Humans ; Hyperthyroidism ; Leg ; Middle Aged ; Mucins ; Myxedema ; Skin ; Thyroid Gland

Pretibial myxedema (PTM) is a asymptomatic localized thickening of the pretibial skin due to deposition of acid mucopolysacharides (glycosaminoglycans). PTM, Graves' ophthalmopathy (GO) and thyroid acropachy are the triad of classic extrathyroidal manifestations of Graves' disease. PTM usually follows the onset of GO, and PTM develops after the diagnosis and treatment of hyperthyroidism. We report here on a 51-year-old female who presented with painful, well demarcated hyperpigmented plaques with nonpitting edema on both lower legs. The histopathologic findings showed an increased accumulation of mucin throughout dermis. In our patient, PTM was the earliest manifestation and this led to the diagnosis of Graves' disease.
Dermis ; Edema ; Female ; Graves Disease ; Humans ; Hyperthyroidism ; Leg ; Middle Aged ; Mucins ; Myxedema ; Skin ; Thyroid Gland

Pretibial myxedema, which consists of localized cutaneous accumulations of acid mucopolyeaccharides, occurs in a small percentage of patients with diffuse toxic goiter. Pretibial myxedema may also occur during the course of nonthyrotoxic thyroid disease. A case of pretibial myxedema with diffuse toxic goiter in 64 year-old female is reported. She has been suffered from thickened yellowish waxy pIaques on both pretibial areas and left dorsum of foot. Initial skin lesions developed about 7 months ago, and increased its size and numbers insidiously. Diagnosis was confirmed by characteristic clinical, laboratory and histopathological findings. Literatures were reviewed.
Diagnosis ; Female ; Foot ; Goiter* ; Humans ; Middle Aged ; Myxedema* ; Skin ; Thyroid Diseases

Rhabdomyolysis is defined as skeletal muscle injury with release of muscle cell constituents into the plasma. Trauma and drugs are important causes of rhabdomyolysis and not rarely it is associated with metabolic disorders such as diabetic coma, severe electrolyte disturbances and myxedema coma. There are a few reports about rhabdomyolysis developed in patient with thyroid storm. which is defined as a sudden, life threatening exacerbation of thyrotoxicosis. In this report, we described the case of thyroid storm complicated by rhabdomyolysis.
Coma ; Diabetic Coma ; Humans ; Muscle Cells ; Muscle, Skeletal ; Myxedema ; Plasma ; Rhabdomyolysis* ; Thyroid Crisis* ; Thyroid Gland* ; Thyrotoxicosis

The diseases which present with cutaneous sclerodermatous changes are scleroderma, eosinophilic fasciitis, mixed connective tissue disease, sclerederma adultorum, scleromyxedema and cutaneous midline mucinosis. This paper reviews the characteristics and differential diagnosis among of the above mentioned diseases.
Diagnosis, Differential ; Fasciitis/diagnosis ; Human ; Myxedema/diagnosis ; Scleredema Adultorum/diagnosis ; Scleroderma, Circumscribed/diagnosis* ; Scleroderma, Systemic/diagnosis

We report a case of pretibial myxedema with hypothyroidism in a 52-year-old woman. She suffered from primary hypothyroidism for a period of 17 years. She was treated with a daily dose of sodium levothyroxine 0.2 mg intermittently. She had erythematous ftesh colored, hard and thickened plaque. on the left pretibial area for onr year. The histopathologic findings showed considerable amount of muci in the upper and mid dermis. Toluidine blue and alcian blue stain demonstrated an extensive deposition of dermal mucin. We treated her with a topical steroid and oral sodium levothyrcxire.
Alcian Blue ; Dermis ; Female ; Humans ; Hypothyroidism* ; Middle Aged ; Mucins ; Myxedema* ; Sodium ; Thyroxine ; Tolonium Chloride

Hypertrichosis is an overgrowth of hair not localized to the anclro en dependent areas of the skin. It may be congenital or acquired, localized or generalized localized hypertrichosis may occur in some types of pigrnentary nevi, chronic inflammation or irration, topical application of androgen or steroid, & localized myxedema. We report herein three i:ases of unilateral localized hypertrichosis with or without a brownish hyperpigmented patch developing on the face of a male adol scent. There are no known cau:,es of localized hyper trichosis. Histopath logically, it is characterized by increased melaniii pigment in the basal layer of the epidermis & enlarged hair follicles containing coarser liair. Electron microscopic findings show normal size & number of melanosomes in both mela nocytes & keratinocytes. Our cases differ frorn BecLers nevus in both clinical & histopatholcgic characteristics.
Epidermis ; Hair ; Hair Follicle ; Humans ; Hypertrichosis* ; Inflammation ; Keratinocytes ; Logic ; Male ; Melanosomes ; Myxedema ; Nevus ; Skin