Utility of myxedema score as a predictor of mortality in myxedema coma

Chaudhary, Shakun; Das, Liza; Sharma, Navneet; Sachdeva, Namrata; Bhansali, Anil; Dutta, Pinaki

doi:10.1007/s40618-022-01884-6

Cited by 12 publications

(9 citation statements)

References 13 publications

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“…Moreover, it has been suggested that the term MC can be misleading, since not all patients with severe hypothyroidism present with coma. Hemodynamic and ventilation failures are also frequent clinical presentations associated with worse outcomes [4][5]17]. The validity of the MC score for diagnosing severe hypothyroidism was con rmed by two recent larger studies for patients with primary but also central hypothyroidism [4,17].…”

Section: Discussionmentioning

confidence: 98%

Increased incidence of myxedema coma during the COVID-19 pandemic and in the post pandemic era: a single-center case series

Sokołowski,

Studen,

Opalinska

et al. 2024

Preprint

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Introduction: The COVID-19 pandemic was a major challenge for all health care employees, but it was also difficult for patients to gain access to health care services. Myxedema coma (MC) is an exteremely rare but potentially fatal endocrine emergency. Objectives: The aim of the study was to report an increased incidence of life-threatening myxedema coma that occurred in relation to the COVID-19 pandemic. Material and Methods: In this paper, we report a cohort of 11 patients with MC who were treated at the University Hospital in Krakow, Poland, in the period from 2015–2023. Only 1 case of MC was recorded in the period from 2015–2019, and, in the same area, 10 cases of MC were recorded after the start of COVID-19 pandemic until present. Results: Hypothyroidism was diagnosed de novo in 2 (18%) patients; the remaining patients were severely hypothyroid due to therapy non-compliance. Nine patients had primary hypothyroidism, and 2 had central hypothyroidism. Besides longstanding hypothyroidism, an additional precipitating factor for MC was identified in 4 (36%) of the patients. Due to the inaccessibility of parenteral levothyroxine, patients were treated with oral, mostly liquid, form of levothyroxine. The mortality rate in this cohort was 27.2%. In conclusion, the increase of the incidence of MC, which is a life-threatening complication of inadequately treated hypothyroidism, during the COVID-19 pandemic, when resources were limited, and in the post-pandemic era, underlines the importance of adequate communication with patients and of long term availability of primary care for patients with thyroid disease.

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Section: Discussionmentioning

confidence: 98%

Increased incidence of myxedema coma during the COVID-19 pandemic and in the post pandemic era: a single-center case series

Sokołowski,

Studen,

Opalinska

et al. 2024

Preprint

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“…Points were given for his degree of hypothermia, somnolent state, bradycardia, hypotension, hypercarbia, and decrease in GFR. Studies also go further to suggest that higher scores had significantly higher mortality, with myxedema coma score above 110 showing 100% mortality, making this condition a true medical emergency [ 5 ]. Therefore it is of utmost importance that once the diagnosis is suspected or identified, treatment is initiated.…”

Section: Discussionmentioning

confidence: 99%

A Case of Myxedema Coma and Respiratory Failure

Clarke

2023

Cureus

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Myxedema coma is a rare, but potentially fatal condition due to severe hypothyroidism, and most commonly seen in patients with long standing, untreated hypothyroidism. Here, I report a case of a 75-year-old male who presented to the emergency department with acute respiratory failure and altered mental status. Interestingly, this case led to a new diagnosis of hypothyroidism presenting in its most severe form - myxedema coma. This case highlights the diagnostic challenges in identifying patients with myxedema coma and recognizing its potential role as a cause of respiratory failure.

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“…MC is a form of decompensated hypothyroidism characterized by multi-system organ dysfunction [2]. A verified myxedema score may be used to distinguish the overlapping symptomatology of MC from other common medical conditions while predicting mortality in patients.…”

Section: Discussionmentioning

confidence: 99%

“…The patient had a myxedema score of 75 and was started on intravenous levothyroxine and hydrocortisone [2]. On postoperative day 27, the patient regained consciousness, was extubated, and complained of blurry vision in both eyes.…”

Section: Case Presentationmentioning

confidence: 99%

Optic Neuropathy Following Acute Decompensated Hypothyroidism (Myxedema Crisis)

McBee,

Lee,

Zhou

et al. 2023

Cureus

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Myxedema crisis (MC) refers to an unusual state of regulatory dysfunction precipitated by uncontrolled hypothyroidism. The pathogenic consequences of MC are broad and may contribute to significant bodily decompensation across multiple organ systems. However, shock-induced ischemic optic neuropathy (SION) in this setting has not been reported previously. Here, we present the case of a 76-year-old female with presumed bilateral optic neuropathy following abdominal surgery. The patient experienced a prolonged and complicated postoperative course in which she remained off supplemental levothyroxine. Subsequently, her clinical status deteriorated until she met diagnostic criteria for acute decompensated hypothyroidism (MC). Upon awakening from a comatose state, she reported significant vision loss. A neuro-ophthalmologic evaluation later confirmed significant constriction of her visual fields, optic disc pallor, and global retinal nerve fiber layer loss consistent with nonarteritic ischemic optic neuropathy.

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Utility of myxedema score as a predictor of mortality in myxedema coma

Cited by 12 publications

References 13 publications

Increased incidence of myxedema coma during the COVID-19 pandemic and in the post pandemic era: a single-center case series

Increased incidence of myxedema coma during the COVID-19 pandemic and in the post pandemic era: a single-center case series

A Case of Myxedema Coma and Respiratory Failure

Optic Neuropathy Following Acute Decompensated Hypothyroidism (Myxedema Crisis)

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