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Myxoedema coma 

Myxoedema coma
Chapter:
Myxoedema coma
Author(s):

Joanna Klubo-Gwiezdzinska

and Leonard Wartofsky

DOI:
10.1093/med/9780199235292.003.3248
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date: 12 December 2017

Myxoedema coma is the extreme expression of severe hypothyroidism and fortunately is quite rare. The first reported case appears to have been in 1879 by Ord from St Thomas’s Hospital, London. Two other patients who died in a hypothyroid coma were reported in 1888 in the proceedings of the Clinical Society of London (1). The next cases in the literature appeared in 1953 (2, 3), and some 300 cases have since been reported. Epidemiological data indicate an incidence rate of 0.22/1 000 000 per year (4). The most common presentation of the syndrome is in hospitalized elderly women with long-standing hypothyroidism, with 80% of cases occurring in women over 60 years of age. However, myxoedema coma occurs in younger patients as well, with 36 documented cases occurring during pregnancy (5, 6). In spite of early diagnosis and treatment, the mortality rate may be as high as 40–60%.

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