Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Key clinical features used to identify a patient with myxoedema coma include:
- Profound hypothermia, often with body temperature below 35°C.
- Altered mental status ranging from lethargy and confusion to coma.
- Bradycardia and hypotension reflecting cardiovascular depression.
- Respiratory depression leading to hypoventilation and hypercapnia.
- Non-pitting oedema, particularly facial and peripheral, characteristic of severe hypothyroidism.
- Dry, coarse skin and hair thinning or loss.
- Hyponatraemia and hypoglycaemia as metabolic disturbances.
- Reduced reflexes and sometimes seizures due to central nervous system involvement.
These features reflect the severe decompensation of hypothyroidism and multi-organ dysfunction seen in myxoedema coma, which is a rare but life-threatening endocrine emergency NICE NG145 Spitzweg et al. 2017De Sanctis et al. 2021.