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Case Reports
. 2015 Mar 25:2015:bcr2014209071.
doi: 10.1136/bcr-2014-209071.

Complete recovery after severe myxoedema coma complicated by status epilepticus

Jesper Fjølner  1 , Esben Søndergaard  2 , Ulla Kampmann  2 , Søren Nielsen  2
Affiliations
Case Reports

Complete recovery after severe myxoedema coma complicated by status epilepticus

Jesper Fjølner et al. BMJ Case Rep. .

Abstract

We report a case of life-threatening myxoedema presenting with hypothermia, hypotension, bradycardia, pericardial effusion and deep coma. The condition was complicated by prolonged status epilepticus. The optimal treatment strategy has been debated over the years and the literature is briefly reviewed. Treatment with l-thyroxine (LT4) monotherapy without initial loading dose and with no l-triiodothyronine (LT3) treatment was successful with full recovery after hospitalisation for more than a month. Myxoedema coma is a rare, reversible condition with a high mortality and should be considered as a differential diagnosis in medical emergencies.

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Figures

Figure 1
Figure 1
ECG showing first degree atrioventricular block and low voltage.
Figure 2
Figure 2
CT scan on arrival showing a large pericardial effusion.
See this image and copyright information in PMC

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