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Myxedema

MedGen UID:
6506
•Concept ID:
C0027145
•
Disease or Syndrome
Synonym: Myxedemas
SNOMED CT: Myxedema (43153006)
 
Monarch Initiative: MONDO:0009718
OMIM®: 255900

Definition

A condition characterized by severe hypothyroidism that is caused by autoimmune thyroid gland disorders, surgical reduction of thyroid tissue, radiation exposure, and viral infections. Signs and symptoms include generalized fatigue, lethargy, increased body weight, pale, edematous and thickened skin, low blood pressure, constipation and cold intolerance. [from NCI]

Clinical features

From HPO
Fatigue
MedGen UID:
41971
•Concept ID:
C0015672
•
Sign or Symptom
A subjective feeling of tiredness characterized by a lack of energy and motivation.
See: Feature record | Search on this feature
Constipation
MedGen UID:
1101
•Concept ID:
C0009806
•
Sign or Symptom
Infrequent or difficult evacuation of feces.
See: Feature record | Search on this feature
Lethargy
MedGen UID:
7310
•Concept ID:
C0023380
•
Sign or Symptom
A state of disinterestedness, listlessness, and indifference, resulting in difficulty performing simple tasks or concentrating.
See: Feature record | Search on this feature
Paresthesia
MedGen UID:
14619
•Concept ID:
C0030554
•
Disease or Syndrome
Abnormal sensations such as tingling, pricking, or numbness of the skin with no apparent physical cause.
See: Feature record | Search on this feature
Memory impairment
MedGen UID:
68579
•Concept ID:
C0233794
•
Mental or Behavioral Dysfunction
An impairment of memory as manifested by a reduced ability to remember things such as dates and names, and increased forgetfulness.
See: Feature record | Search on this feature
Easy fatigability
MedGen UID:
373253
•Concept ID:
C1837098
•
Finding
Increased susceptibility to fatigue.
See: Feature record | Search on this feature
Muscle spasm
MedGen UID:
52431
•Concept ID:
C0037763
•
Sign or Symptom
Sudden and involuntary contractions of one or more muscles.
See: Feature record | Search on this feature
Muscle weakness
MedGen UID:
57735
•Concept ID:
C0151786
•
Finding
Reduced strength of muscles.
See: Feature record | Search on this feature
Hoarse voice
MedGen UID:
5602
•Concept ID:
C0019825
•
Sign or Symptom
Hoarseness refers to a change in the pitch or quality of the voice, with the voice sounding weak, very breathy, scratchy, or husky.
See: Feature record | Search on this feature
Abnormality of the voice
MedGen UID:
867406
•Concept ID:
C4021776
•
Finding
See: Feature record | Search on this feature
Hypohidrosis
MedGen UID:
43796
•Concept ID:
C0020620
•
Disease or Syndrome
Abnormally diminished capacity to sweat.
See: Feature record | Search on this feature
Dry skin
MedGen UID:
56250
•Concept ID:
C0151908
•
Sign or Symptom
Skin characterized by the lack of natural or normal moisture.
See: Feature record | Search on this feature
Goiter
MedGen UID:
42270
•Concept ID:
C0018021
•
Disease or Syndrome
An enlargement of the thyroid gland.
See: Feature record | Search on this feature
Hypothyroidism
MedGen UID:
6991
•Concept ID:
C0020676
•
Disease or Syndrome
Deficiency of thyroid hormone.
See: Feature record | Search on this feature
Elevated circulating thyroid-stimulating hormone concentration
MedGen UID:
108325
•Concept ID:
C0586553
•
Finding
Increased concentration of thyroid-stimulating hormone (TSH) in the blood circulation.
See: Feature record | Search on this feature
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Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVMyxedema

Professional guidelines

PubMed

Hypothyroidism: Diagnosis and Treatment.
Wilson SA, Stem LA, Bruehlman RD
Am Fam Physician 2021 May 15;103(10):605-613. PMID: 33983002
Amiodarone and thyroid physiology, pathophysiology, diagnosis and management.
Trohman RG, Sharma PS, McAninch EA, Bianco AC
Trends Cardiovasc Med 2019 Jul;29(5):285-295. Epub 2018 Sep 20 doi: 10.1016/j.tcm.2018.09.005. PMID: 30309693Free PMC Article
Myxedema coma: diagnosis and treatment.
Wall CR
Am Fam Physician 2000 Dec 1;62(11):2485-90. PMID: 11130234

Recent clinical studies

Etiology

Hyperthyroidism Symptoms, Management, and Outcomes in Children and Adults Seeking Definitive Surgical Treatment.
Chung SK, Asban A, Hur J, Iyer P, Chen H
Ann Surg 2021 May 1;273(5):e181-e182. doi: 10.1097/SLA.0000000000004053. PMID: 32773619
Graves' disease: Clinical manifestations, immune pathogenesis (cytokines and chemokines) and therapy.
Antonelli A, Fallahi P, Elia G, Ragusa F, Paparo SR, Ruffilli I, Patrizio A, Gonnella D, Giusti C, Virili C, Centanni M, Shoenfeld Y, Ferrari SM
Best Pract Res Clin Endocrinol Metab 2020 Jan;34(1):101388. Epub 2020 Feb 4 doi: 10.1016/j.beem.2020.101388. PMID: 32059832
Amiodarone and thyroid physiology, pathophysiology, diagnosis and management.
Trohman RG, Sharma PS, McAninch EA, Bianco AC
Trends Cardiovasc Med 2019 Jul;29(5):285-295. Epub 2018 Sep 20 doi: 10.1016/j.tcm.2018.09.005. PMID: 30309693Free PMC Article
WITHDRAWN: Iodine supplementation for preventing iodine deficiency disorders in children.
Angermayr L, Clar C
Cochrane Database Syst Rev 2018 Nov 29;11(11):CD003819. doi: 10.1002/14651858.CD003819.pub3. PMID: 30489630Free PMC Article
Myxedema coma: diagnosis and treatment.
Wall CR
Am Fam Physician 2000 Dec 1;62(11):2485-90. PMID: 11130234

Diagnosis

Hypothyroidism: Diagnosis and Treatment.
Wilson SA, Stem LA, Bruehlman RD
Am Fam Physician 2021 May 15;103(10):605-613. PMID: 33983002
Hypothyroidism.
McDermott MT
Ann Intern Med 2020 Jul 7;173(1):ITC1-ITC16. doi: 10.7326/AITC202007070. PMID: 32628881
Thyroid emergencies.
Ylli D, Klubo-Gwiezdzinska J, Wartofsky L
Pol Arch Intern Med 2019 Aug 29;129(7-8):526-534. Epub 2019 Jun 25 doi: 10.20452/pamw.14876. PMID: 31237256Free PMC Article
Myxedema coma.
Kwaku MP, Burman KD
J Intensive Care Med 2007 Jul-Aug;22(4):224-31. doi: 10.1177/0885066607301361. PMID: 17712058
Myxedema coma: diagnosis and treatment.
Wall CR
Am Fam Physician 2000 Dec 1;62(11):2485-90. PMID: 11130234

Therapy

Hypothyroidism.
McDermott MT
Ann Intern Med 2020 Jul 7;173(1):ITC1-ITC16. doi: 10.7326/AITC202007070. PMID: 32628881
Amiodarone and thyroid physiology, pathophysiology, diagnosis and management.
Trohman RG, Sharma PS, McAninch EA, Bianco AC
Trends Cardiovasc Med 2019 Jul;29(5):285-295. Epub 2018 Sep 20 doi: 10.1016/j.tcm.2018.09.005. PMID: 30309693Free PMC Article
WITHDRAWN: Iodine supplementation for preventing iodine deficiency disorders in children.
Angermayr L, Clar C
Cochrane Database Syst Rev 2018 Nov 29;11(11):CD003819. doi: 10.1002/14651858.CD003819.pub3. PMID: 30489630Free PMC Article
Thyroid emergencies.
Klubo-Gwiezdzinska J, Wartofsky L
Med Clin North Am 2012 Mar;96(2):385-403. Epub 2012 Feb 17 doi: 10.1016/j.mcna.2012.01.015. PMID: 22443982
Myxedema coma: diagnosis and treatment.
Wall CR
Am Fam Physician 2000 Dec 1;62(11):2485-90. PMID: 11130234

Prognosis

Neurological Complications of Endocrine Emergencies.
Cruz-Flores S
Curr Neurol Neurosci Rep 2021 Mar 11;21(5):21. doi: 10.1007/s11910-021-01105-2. PMID: 33709163
Thyroid gland and brain: Enigma of Hashimoto's encephalopathy.
Churilov LP, Sobolevskaia PA, Stroev YI
Best Pract Res Clin Endocrinol Metab 2019 Dec;33(6):101364. Epub 2019 Nov 23 doi: 10.1016/j.beem.2019.101364. PMID: 31801687
Amiodarone and thyroid physiology, pathophysiology, diagnosis and management.
Trohman RG, Sharma PS, McAninch EA, Bianco AC
Trends Cardiovasc Med 2019 Jul;29(5):285-295. Epub 2018 Sep 20 doi: 10.1016/j.tcm.2018.09.005. PMID: 30309693Free PMC Article
A diagnostic scoring system for myxedema coma.
Popoveniuc G, Chandra T, Sud A, Sharma M, Blackman MR, Burman KD, Mete M, Desale S, Wartofsky L
Endocr Pract 2014 Aug;20(8):808-17. doi: 10.4158/EP13460.OR. PMID: 24518183
Myxedema coma: diagnosis and treatment.
Wall CR
Am Fam Physician 2000 Dec 1;62(11):2485-90. PMID: 11130234

Clinical prediction guides

History of the Thyroid.
Connelly KJ, Park JJ, LaFranchi SH
Horm Res Paediatr 2022;95(6):546-556. Epub 2022 Nov 29 doi: 10.1159/000526621. PMID: 36446327
Systematic review of COVID-19 and autoimmune thyroiditis.
Tutal E, Ozaras R, Leblebicioglu H
Travel Med Infect Dis 2022 May-Jun;47:102314. Epub 2022 Mar 18 doi: 10.1016/j.tmaid.2022.102314. PMID: 35307540Free PMC Article
Thyroid emergencies.
Ylli D, Klubo-Gwiezdzinska J, Wartofsky L
Pol Arch Intern Med 2019 Aug 29;129(7-8):526-534. Epub 2019 Jun 25 doi: 10.20452/pamw.14876. PMID: 31237256Free PMC Article
Amiodarone and thyroid physiology, pathophysiology, diagnosis and management.
Trohman RG, Sharma PS, McAninch EA, Bianco AC
Trends Cardiovasc Med 2019 Jul;29(5):285-295. Epub 2018 Sep 20 doi: 10.1016/j.tcm.2018.09.005. PMID: 30309693Free PMC Article
A diagnostic scoring system for myxedema coma.
Popoveniuc G, Chandra T, Sud A, Sharma M, Blackman MR, Burman KD, Mete M, Desale S, Wartofsky L
Endocr Pract 2014 Aug;20(8):808-17. doi: 10.4158/EP13460.OR. PMID: 24518183

Recent systematic reviews

Systematic review of COVID-19 and autoimmune thyroiditis.
Tutal E, Ozaras R, Leblebicioglu H
Travel Med Infect Dis 2022 May-Jun;47:102314. Epub 2022 Mar 18 doi: 10.1016/j.tmaid.2022.102314. PMID: 35307540Free PMC Article
Myxedema Madness - Systematic literature review of published case reports.
Krüger J, Kraschewski A, Jockers-Scherübl MC
Gen Hosp Psychiatry 2021 Sep-Oct;72:102-116. Epub 2021 Aug 14 doi: 10.1016/j.genhosppsych.2021.08.005. PMID: 34419786
Amiodarone and thyroid physiology, pathophysiology, diagnosis and management.
Trohman RG, Sharma PS, McAninch EA, Bianco AC
Trends Cardiovasc Med 2019 Jul;29(5):285-295. Epub 2018 Sep 20 doi: 10.1016/j.tcm.2018.09.005. PMID: 30309693Free PMC Article
WITHDRAWN: Iodine supplementation for preventing iodine deficiency disorders in children.
Angermayr L, Clar C
Cochrane Database Syst Rev 2018 Nov 29;11(11):CD003819. doi: 10.1002/14651858.CD003819.pub3. PMID: 30489630Free PMC Article
Iodine supplementation for preventing iodine deficiency disorders in children.
Angermayr L, Clar C
Cochrane Database Syst Rev 2004;(2):CD003819. doi: 10.1002/14651858.CD003819.pub2. PMID: 15106221

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    Reviews

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