[Thyroid Storm and Myxedema Coma]

Abstract

Thyrotoxic crisis and myxedema coma are rare but highly life-threatening endocrinological emergencies. Both conditions require rapid clinical diagnosis and intensive care treatment, as mortality remains high despite treatment (up to 30% in thyrotoxic crisis, up to 60% in myxedema coma). While thyrotoxic crisis is characterized by hypermetabolism with fever, tachycardia, agitation, and multiorgan failure, myxedema coma manifests as a hypometabolic state with hypothermia, bradycardia, impaired consciousness, and respiratory failure. Diagnosis is primarily based on the clinical picture; laboratory findings should not delay initiation of treatment. Both emergencies usually arise from decompensation of a known thyroid disorder under the influence of precipitating factors, the identification and treatment of which are essential. Treatment for thyrotoxic crisis includes the simultaneous administration of beta-blockers, high-dose antithyroid drugs, glucocorticoids, and intensive care support. In myxedema coma, immediate intravenous hormone replacement (L-thyroxine) and hydrocortisone administration are paramount. Interdisciplinary care and consistent follow-up treatment of the underlying disease are crucial for the prognosis.