Case Report

Volume: 6 | Issue: 9 | Published: Dec 19, 2022 | Pages: 177 - 183 | DOI: 10.24911/ejmcr/173-1664645776

Anamnesis of rare severe decompensated hypothyroid emergency managementmyxedema crisis


Authors: Tanveer Hussain , Shahzad Nisar Khan


Article Info

Authors

Tanveer Hussain

Royal Oman Police Hospital, Muscat Oman

Shahzad Nisar Khan

Royal Oman Police Hospital, Muscat Oman.

Publication History

Received: October 07, 2022

Revised: November 19, 2022

Accepted: November 19, 2022

Published: December 19, 2022


Abstract


Background: Myxedema crisis is a rare decompensated hypothyroid clinical condition with high mortality if remains unrecognized. Case presentation: We report a case of 36-year old male with a 3 week history of difficulty in breathing and facial puffiness. Periorbital edema, very dry skin, and non-pitting edema of legs was noticed on clinical examination. The patient was commenced on oral thyroxine for abnormal thyroid functions but deteriorated over the next few days. A diagnosis of myxedema crisis was made and was treated with a loading dose of oral thyroxine followed by maintenance dose along with intravenous steroids and intravenous antibiotics. Thyroxine dose was adjusted with serial thyroid functions on alternate days to confirm absorption. The patient clinically improved as thyroid functions advanced toward normalization. Conclusion: Myxedema crisis remains poorly recognized condition due to extremely rare endocrine emergency. Under circumstances where intravenous hormone not available, oral thyroxine with daily or alternate day thyroid hormone level to confirm absorption and to adjust dose is equally effective way of management. Patient must be considered for an adrenal insufficiency unless proven otherwise.

Keywords: Case report, myxoedema crisis, thyroxine, steroids, antibiotics, adrenal insufficiency, green


Pubmed Style

Tanveer Hussain, Shahzad Nisar Khan. Anamnesis of rare severe decompensated hypothyroid emergency managementmyxedema crisis. EJMCR. 2022; 19 (December 2022): 177-183. doi:10.24911/ejmcr/173-1664645776

Web Style

Tanveer Hussain, Shahzad Nisar Khan. Anamnesis of rare severe decompensated hypothyroid emergency managementmyxedema crisis. https://ejmcr.com/articles/1110 [Access: December 25, 2024]. doi:10.24911/ejmcr/173-1664645776

AMA (American Medical Association) Style

Tanveer Hussain, Shahzad Nisar Khan. Anamnesis of rare severe decompensated hypothyroid emergency managementmyxedema crisis. EJMCR. 2022; 19 (December 2022): 177-183. doi:10.24911/ejmcr/173-1664645776

Vancouver/ICMJE Style

Tanveer Hussain, Shahzad Nisar Khan. Anamnesis of rare severe decompensated hypothyroid emergency managementmyxedema crisis. EJMCR. (2022), [cited December 25, 2024]; 19 (December 2022): 177-183. doi:10.24911/ejmcr/173-1664645776

Harvard Style

Tanveer Hussain, Shahzad Nisar Khan (2022) Anamnesis of rare severe decompensated hypothyroid emergency managementmyxedema crisis. EJMCR, 19 (December 2022): 177-183. doi:10.24911/ejmcr/173-1664645776

Chicago Style

Tanveer Hussain, Shahzad Nisar Khan. "Anamnesis of rare severe decompensated hypothyroid emergency managementmyxedema crisis." 19 (2022), 177-183. doi:10.24911/ejmcr/173-1664645776

MLA (The Modern Language Association) Style

Tanveer Hussain, Shahzad Nisar Khan. "Anamnesis of rare severe decompensated hypothyroid emergency managementmyxedema crisis." 19.December 2022 (2022), 177-183. Print. doi:10.24911/ejmcr/173-1664645776

APA (American Psychological Association) Style

Tanveer Hussain, Shahzad Nisar Khan (2022) Anamnesis of rare severe decompensated hypothyroid emergency managementmyxedema crisis. , 19 (December 2022), 177-183. doi:10.24911/ejmcr/173-1664645776