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Myxedema, Shock and Coma: Seven Survival Cases

Myxedema, Shock and Coma: Seven Survival Cases Abstract In the last 7 years numerous reports1-15 have appeared in the British Medical literature dealing with myxedema, shock, and coma. A survey of these reports indicates that 19 out of 25 patients died in spite of vigorous treatment with corticosteroids, vasopressors, thyroid compounds, antibiotics, warming, and electrolyte and fluid correction. Frequently, an infectious process was present, and the syndrome of myxedemacoma was characterized in many instances by hypothermia, hypotension, cardiac failure, and low serum and chloride. Death was due to peripheric vascular failure. In the American medical literature, we have 3 reports16-18 of myxedema-coma. One of these patients was also in shock. There were no survivors. The object of this study is to report 6 survival cases of myxedema with coma and shock and one survival case of myxedema in shock. We believe they are the first survival cases to be reported in the United States. This study References 1. Le Marquand, H. S.; Hausmann, W., and Hemsted, E. H.: Myxoedema as Cause of Death: Report of Two Cases , Brit. Med. J. 1:704-706, 1953.Crossref 2. Martin, L., and Whittle, C.: Myxedema as a Cause of Death , Brit. Med. J. 1:1108, 1953.Crossref 3. Summers, V. K.: Myxedema Coma , Brit. Med. J. 2:366-368, 1953.Crossref 4. Brotmacher, L., and Coghill, N. F.: Myxedema Coma , Brit. Med. J. 2:886, 1953.Crossref 5. Malden, M.: Hypothemic Coma in Myxedema , Brit. Med. J. 2:764-766, 1955.Crossref 6. Karhausen, L., and Zylberszac, S.: Myxedema Coma in Patient with Hashimoto's Struma , Brit. Med. J. 2:766-768, 1955.Crossref 7. Le Marquand, H. S.: Hausmann, W., and Hemsted, E. H.: Death in Myxedema Coma , Brit. Med. J. 2:773, 1955.Crossref 8. Ried, H.: Myxedema Coma , Brit. Med. J. 2:967, 1955.Crossref 9. Marshall, R. J., and McCaughey, W. T. E.: Hypothermic Myxedema Coma with Muscle Damage and Acute Renal Tubular Necrosis , Lancet 2:754-757, 1956.Crossref 10. Dyson, A., and Wood, M. W. W.: Triiodothyronine in Myxedema Coma , Lancet 2:757-759, 1956.Crossref 11. Anderson, A., and Hausmann, W.: Triiodothyronine in Myxedema Coma , Lancet 2:999, 1956.Crossref 12. Knyrett, A. F., and Steinbeck, A. W.: Case of Myxedema Coma , Med. J. Aust. 1:722-724, 1957. 13. MacDonald, D. W.: Hypothermic Myxedema Coma: Three Case Reports , Brit. Med. J. 2:1144-1146, 1958.Crossref 14. Surtus, S., and Ginsberg, S.: A Case of Myxedema Coma Successfully Treated with Triiodothyronine , Postgrad. Med. J. (England) 34: 443, 1958.Crossref 15. Mitchell, J. R. A.; Surridge, D. H. C., and Willison, R. G.: Hypothermia After Chlorpromazine in Myxedematous Psychosis , Brit. Med. J. 2: 932-933, 1959.Crossref 16. Levin, M. E., and Daughaday, W. H.: Fatal Coma Due to Myxedema , Amer. J. Med. 18:1017-1021, 1958.Crossref 17. Curtis, R. H.: Hyponatremia in Primary Myxedema , Ann. Intern. Med. 44:376-385, 1956.Crossref 18. Kelly, J. J., and Sherk, H. H.: Myxedema Coma , Ann. Intern. Med. 50:1303-1309, 1959.Crossref 19. Brewster, W. R.; Isaacs, J. P.; Osgood, P. F., and King, T. L.: The Hemodynamic and Metabolic Interrelationships in the Activity of Epinephrine, Norepinephrine and the Thyroid Hormones , Circulation 13:1-20, 1956.Crossref 20. Schneckloth, R. E.; Kurland, G. S., and Freedberg, A. S.: Effect of Variation in Thyroid Function on the Pressor Response to Norepinephrine in Man , Metabolism 2:546, 1953. 21. Murray, J. F., and Kelley, J. J., Jr.: The Relation of Thyroidal Hormone Level to Epinephrine Response: A Diagnostic Test for Hyperthyroidism , Ann. Intern. Med. 51:309-321, 1959.Crossref 22. Kurland, G. S., and Freedberg, A. S.: The Potentiating Effect of ACTH and of Cortisone on Pressor Response to Intravenous Infusion of 1-Norepinephrine , Proc. Soc. Exp. Biol. Med. 78: 28-31, 1951.Crossref 23. Aikawa, J. K.: The Nature of Myxedema: Alterations in the Serum Electrolyte Concentrations and Radiosodium Space and in the Exchangeable Sodium and Potassium Contents , Ann. Intern. Med. 44:30-39, 1956.Crossref 24. Hubble, D.: Endocrine Relations , Lancet 1: 1, 1955.Crossref 25. Statland, H., and Lerman, J.: Function of Adrenal Cortex in Myxedema with Some Observations on Pituitary Function , J. Clin. Endocr. 10: 1401, 1950.Crossref 26. Paull, A. M., and Phillips, R. W.: Primary Myxedema with Secondary Adrenocortical Failure , J. Clin. Endocr. 14:554, 1954.Crossref 27. Zarrow, M. X., and Money, W. L.: The Involution of the Adrenal Cortex of Rats Treated with Thiouracil , Endocrinology 44:345, 1949.Crossref 28. Zarrow, M. X., and Zarrow, I. G.: Mechanism of Adrenal Involution in the Rat After Treatment with Thiouracil , Proc. Soc. Exp. Biol. Med. 76:620, 1951.Crossref 29. Douglass, R. C., and Jacobson, S. D.: Pathologic Changes in Adult Myxedema: Survey of 10 Necropsies , J. Clin. Endocr. 17:1354, 1957.Crossref 30. Levin, M. E., and Daughaday, W. H.: The Influence of the Thyroid on Adrenocortical Function , J. Clin. Endocr. 15:1499, 1955.Crossref 31. Williams, G. A.; Crispell, K. R., and Parson, W.: Adrenocortical Function in Myxedema , J. Clin. Endocr. 17:1347, 1957.Crossref 32. Di Raimondo, V. C.; Sagan, L.; Perloff, P., and Forsham, P. H.: The Effect of Hyper- and Hypothyroidism on Adrenal Cortical Activity in Man , Clin. Res. 6:93, 1958. 33. Felber, J. P.; Reddy, W. J.; Selenkow, H. A., and Thorn, G. W.: Adrenocortical Response to the 48-Hour ACTH Test in Myxedema and Hyperthyroidism , J. Clin. Endocr. 19:895, 1959.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Myxedema, Shock and Coma: Seven Survival Cases

Archives of Internal Medicine , Volume 108 (3) – Sep 1, 1961

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References (30)

Publisher
American Medical Association
Copyright
Copyright © 1961 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1961.03620090079010
Publisher site
See Article on Publisher Site

Abstract

Abstract In the last 7 years numerous reports1-15 have appeared in the British Medical literature dealing with myxedema, shock, and coma. A survey of these reports indicates that 19 out of 25 patients died in spite of vigorous treatment with corticosteroids, vasopressors, thyroid compounds, antibiotics, warming, and electrolyte and fluid correction. Frequently, an infectious process was present, and the syndrome of myxedemacoma was characterized in many instances by hypothermia, hypotension, cardiac failure, and low serum and chloride. Death was due to peripheric vascular failure. In the American medical literature, we have 3 reports16-18 of myxedema-coma. One of these patients was also in shock. There were no survivors. The object of this study is to report 6 survival cases of myxedema with coma and shock and one survival case of myxedema in shock. We believe they are the first survival cases to be reported in the United States. This study References 1. Le Marquand, H. S.; Hausmann, W., and Hemsted, E. H.: Myxoedema as Cause of Death: Report of Two Cases , Brit. Med. J. 1:704-706, 1953.Crossref 2. Martin, L., and Whittle, C.: Myxedema as a Cause of Death , Brit. Med. J. 1:1108, 1953.Crossref 3. Summers, V. K.: Myxedema Coma , Brit. Med. J. 2:366-368, 1953.Crossref 4. Brotmacher, L., and Coghill, N. F.: Myxedema Coma , Brit. Med. J. 2:886, 1953.Crossref 5. Malden, M.: Hypothemic Coma in Myxedema , Brit. Med. J. 2:764-766, 1955.Crossref 6. Karhausen, L., and Zylberszac, S.: Myxedema Coma in Patient with Hashimoto's Struma , Brit. Med. J. 2:766-768, 1955.Crossref 7. Le Marquand, H. S.: Hausmann, W., and Hemsted, E. H.: Death in Myxedema Coma , Brit. Med. J. 2:773, 1955.Crossref 8. Ried, H.: Myxedema Coma , Brit. Med. J. 2:967, 1955.Crossref 9. Marshall, R. J., and McCaughey, W. T. E.: Hypothermic Myxedema Coma with Muscle Damage and Acute Renal Tubular Necrosis , Lancet 2:754-757, 1956.Crossref 10. Dyson, A., and Wood, M. W. W.: Triiodothyronine in Myxedema Coma , Lancet 2:757-759, 1956.Crossref 11. Anderson, A., and Hausmann, W.: Triiodothyronine in Myxedema Coma , Lancet 2:999, 1956.Crossref 12. Knyrett, A. F., and Steinbeck, A. W.: Case of Myxedema Coma , Med. J. Aust. 1:722-724, 1957. 13. MacDonald, D. W.: Hypothermic Myxedema Coma: Three Case Reports , Brit. Med. J. 2:1144-1146, 1958.Crossref 14. Surtus, S., and Ginsberg, S.: A Case of Myxedema Coma Successfully Treated with Triiodothyronine , Postgrad. Med. J. (England) 34: 443, 1958.Crossref 15. Mitchell, J. R. A.; Surridge, D. H. C., and Willison, R. G.: Hypothermia After Chlorpromazine in Myxedematous Psychosis , Brit. Med. J. 2: 932-933, 1959.Crossref 16. Levin, M. E., and Daughaday, W. H.: Fatal Coma Due to Myxedema , Amer. J. Med. 18:1017-1021, 1958.Crossref 17. Curtis, R. H.: Hyponatremia in Primary Myxedema , Ann. Intern. Med. 44:376-385, 1956.Crossref 18. Kelly, J. J., and Sherk, H. H.: Myxedema Coma , Ann. Intern. Med. 50:1303-1309, 1959.Crossref 19. Brewster, W. R.; Isaacs, J. P.; Osgood, P. F., and King, T. L.: The Hemodynamic and Metabolic Interrelationships in the Activity of Epinephrine, Norepinephrine and the Thyroid Hormones , Circulation 13:1-20, 1956.Crossref 20. Schneckloth, R. E.; Kurland, G. S., and Freedberg, A. S.: Effect of Variation in Thyroid Function on the Pressor Response to Norepinephrine in Man , Metabolism 2:546, 1953. 21. Murray, J. F., and Kelley, J. J., Jr.: The Relation of Thyroidal Hormone Level to Epinephrine Response: A Diagnostic Test for Hyperthyroidism , Ann. Intern. Med. 51:309-321, 1959.Crossref 22. Kurland, G. S., and Freedberg, A. S.: The Potentiating Effect of ACTH and of Cortisone on Pressor Response to Intravenous Infusion of 1-Norepinephrine , Proc. Soc. Exp. Biol. Med. 78: 28-31, 1951.Crossref 23. Aikawa, J. K.: The Nature of Myxedema: Alterations in the Serum Electrolyte Concentrations and Radiosodium Space and in the Exchangeable Sodium and Potassium Contents , Ann. Intern. Med. 44:30-39, 1956.Crossref 24. Hubble, D.: Endocrine Relations , Lancet 1: 1, 1955.Crossref 25. Statland, H., and Lerman, J.: Function of Adrenal Cortex in Myxedema with Some Observations on Pituitary Function , J. Clin. Endocr. 10: 1401, 1950.Crossref 26. Paull, A. M., and Phillips, R. W.: Primary Myxedema with Secondary Adrenocortical Failure , J. Clin. Endocr. 14:554, 1954.Crossref 27. Zarrow, M. X., and Money, W. L.: The Involution of the Adrenal Cortex of Rats Treated with Thiouracil , Endocrinology 44:345, 1949.Crossref 28. Zarrow, M. X., and Zarrow, I. G.: Mechanism of Adrenal Involution in the Rat After Treatment with Thiouracil , Proc. Soc. Exp. Biol. Med. 76:620, 1951.Crossref 29. Douglass, R. C., and Jacobson, S. D.: Pathologic Changes in Adult Myxedema: Survey of 10 Necropsies , J. Clin. Endocr. 17:1354, 1957.Crossref 30. Levin, M. E., and Daughaday, W. H.: The Influence of the Thyroid on Adrenocortical Function , J. Clin. Endocr. 15:1499, 1955.Crossref 31. Williams, G. A.; Crispell, K. R., and Parson, W.: Adrenocortical Function in Myxedema , J. Clin. Endocr. 17:1347, 1957.Crossref 32. Di Raimondo, V. C.; Sagan, L.; Perloff, P., and Forsham, P. H.: The Effect of Hyper- and Hypothyroidism on Adrenal Cortical Activity in Man , Clin. Res. 6:93, 1958. 33. Felber, J. P.; Reddy, W. J.; Selenkow, H. A., and Thorn, G. W.: Adrenocortical Response to the 48-Hour ACTH Test in Myxedema and Hyperthyroidism , J. Clin. Endocr. 19:895, 1959.Crossref

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Archives of Internal MedicineAmerican Medical Association

Published: Sep 1, 1961

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