Endocrine Abstracts

Myxoedema coma is a rare life-threatening condition characterised by profound hypothyroidism and altered mental status. Despite its name most patients are not comatose and the presentation is that of decompensated profound hypothyroidism. Due to widespread easy access to thyroid function testing it is very unusual for myxoedema coma to be the first presentation of undiagnosed hypothyroidism. The typical patient is usually an elderly female patient with well-established hypothyroidism (either auto-immune or following definitive treatment for hyperthyroidism), who has poor compliance with levothyroxine with a precipitating event triggering the emergency presentation. Prompt thyroid hormone and glucocorticoid replacement combined with supportive care on a HDU/ITU unit if appropriate is key although mortality may still be as high as 50%.