A case of disturbance of consciousness due to myxedema coma

DOI
  • Ikebe Ryokan
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • Okubo Hikari
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • Osaka Masashi
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • Jaewan Park
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • Oshiro Takuya
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • Saito Makiko
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • Saito Noriko
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • Namiki Mizuho
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • Takeda Munekazu
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • Yaguchi Arino
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University

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Other Title
  • 意識障害の原因として粘液水腫性昏睡が疑われた1例

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Abstract

<p>An 85-year-old woman was transferred to our emergency room due to disturbance of consciousness. When her relatives found her at home, she was lying stark-naked. On arrival at our hospital, the patient's level of consciousness was GCS 10, and her deep body temperature (BT) was 28.0 ℃. She was also markedly dehydrated state. She was immediately rewarmed and resuscitated with fluid. Even after she recovered from hypothermia and dehydration, she was still in the drowsy state. Laboratory findings on the admission showed hypothyroidism with high TSH and low fT3 and fT4 blood levels. She met the diagnostic criteria for myxedema coma, and then levothyroxine sodium, a thyroid hormone, was started. It improved her consciousness to clear. Although myxedema coma is an uncommon disease, its early identification and intervention are required for better prognosis.</p>

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