Coma mixedematoso, reporte de caso

Abstract

Paciente varón de 82 años que ingresa al Servicio de Emergencia por presentar un tiempo de enfermedad de 15 días con hiporexia, disartria, rigidez de miembros superiores e inferiores, en mal estado general, pícnico con edema, lesiones en piel y trastorno del sensorio, bradicardia sostenida; por lo cual al inicio se plantea como problema de insuficiencia respiratoria, trastorno del sensorio a descartar un accidente cerebro vascular. Paciente empeora con mayor compromiso del sensorio y hemodinámico se plantea diagnóstico de coma mixedematoso aplicando el Score Clínico de coma mixedematoso, se inicia tratamiento, paciente fallece.

Coma mixedematoso como causa asociada a falla cardíaca de etiología múltiple. Reporte de caso

“…It is associated with exposure to extremely low temperatures and the development of acute conditions such as sepsis secondary to pneumonia, urinary tract infection and cellulitis, which in the case of developed countries are the most frequently reported (1,5). However, other factors have been identified in Latin American countries such as stroke, acute myocardial infarction, polytrauma (3,6,7), or decompensation of chronic diseases such as heart failure (8).…”

“…Surprisingly, myxedema coma still occurs despite the widespread availability of tests to assess thyroid function and the regular presentation of changes in these hormones, especially hypothyroidism (5). This condition requires a high degree of diagnostic suspicion, but because of its rarity, it is not commonly regarded as a probable diagnosis in the emergency room, so identification and care are delayed, particularly when it presents with atypical symptoms; this lack of diagnostic suspicion overshadows the prognosis (5,7).…”