TY - JOUR
T1 - Myxedema coma in children and adolescents
T2 - A rare endocrine emergency-personal experience and review of literature
AU - de Sanctis, Vincenzo
AU - Soliman, Ashraf
AU - Daar, Shahina
AU - Di Maio, Salvatore
AU - Alhu-Maidi, Noora
AU - Alali, Mayam
AU - Sabt, Aml
AU - Kattamis, Christos
N1 - Publisher Copyright:
© Mattioli 1885.
PY - 2021
Y1 - 2021
N2 - Decompensated hypothyroidism, formerly known as myxedema coma, represents the most extreme clinical expression of severe primary or secondary hypothyroidism in which patients exhibit multiple organ abnormalities and progressive mental deterioration. The exact incidence of myxedema coma in adults is not known, but some authors have estimated that is approximately 0.22 per 100.0000 per year in the western world. Myxedema coma is more common in females and during winter months. The diagnosis of myxedema coma is primarily clinical with supportive evidence of the abnormal thyroid function tests. Clinical features vary depending on a several factors including the age of onset and the severity of the disease. In the majority of patients (95%), the cause of underlying hypothyroidism is autoimmunity, i.e., Hashimoto thyroiditis or congenital abnormalities. Rarely it occurs in secondary (central) hypothyroidism, due to thyrotropin deficien-cy related to pituitary disease, or pituitary-thyroid damage due to iron overload. Treatment consists of thyroid hormone replacement, correction of electrolyte disturbances, passive rewarming, treatment of infections, respiratory and hemodynamic support, and administration of stress-dose glucocorticoids. Prognosis seems to be better in children and adolescents compared to adults. The present review reports personal experience and the literature data on 13 patients. (www.actabiomedica.it).
AB - Decompensated hypothyroidism, formerly known as myxedema coma, represents the most extreme clinical expression of severe primary or secondary hypothyroidism in which patients exhibit multiple organ abnormalities and progressive mental deterioration. The exact incidence of myxedema coma in adults is not known, but some authors have estimated that is approximately 0.22 per 100.0000 per year in the western world. Myxedema coma is more common in females and during winter months. The diagnosis of myxedema coma is primarily clinical with supportive evidence of the abnormal thyroid function tests. Clinical features vary depending on a several factors including the age of onset and the severity of the disease. In the majority of patients (95%), the cause of underlying hypothyroidism is autoimmunity, i.e., Hashimoto thyroiditis or congenital abnormalities. Rarely it occurs in secondary (central) hypothyroidism, due to thyrotropin deficien-cy related to pituitary disease, or pituitary-thyroid damage due to iron overload. Treatment consists of thyroid hormone replacement, correction of electrolyte disturbances, passive rewarming, treatment of infections, respiratory and hemodynamic support, and administration of stress-dose glucocorticoids. Prognosis seems to be better in children and adolescents compared to adults. The present review reports personal experience and the literature data on 13 patients. (www.actabiomedica.it).
KW - Aplastic anemia
KW - Hashimoto thyroiditis
KW - Hypothyroidism
KW - Iron overload
KW - Myxedema coma
KW - Prognosis
KW - Treat-ment
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U2 - 10.23750/abm.v92i5.12252
DO - 10.23750/abm.v92i5.12252
M3 - Review article
C2 - 34738556
AN - SCOPUS:85118824130
SN - 0392-4203
VL - 92
JO - Acta Biomedica
JF - Acta Biomedica
IS - 5
M1 - e2021481
ER -