Myxoedema means severe hypothyroidism in adults and signs
and symptoms are accentuated. The facial appearance is typical
There is often supraclavicular puffiness, a malar flush and
a yellow tinge to the skin
Myxoedema coma, characterised by altered mental status,
hypothermia and a precipitating medical condition, for example cardiac failure
or infection, carries a high mortality rate
Treatment
Thyroid replacement: Either a bolus of 500 mg T4 or 10 micro
gram T3 either intravenously or orally every 4-6 hours
For hypothermia(<30 degree) body is warmed slowly
Intravenous broad spectrum antibiotics and steroids
Primary or atrophic myxoedema is considered to be an
autoimmune disease similar to chronic lymphocytic thyroiditis Hashimotos) but
without Goiter formation,and there is delay in diagnosis and hypothyroidism is
severe
Ref : Bailey and Love
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