A Case of Respiratory Failure Due to Myxedema Coma
Author(s): Arvindh Manohar* and Anandh Mohan
An 80 year old female was brought into the emergency department with loss of consciousness and not responding to pain, she had history of altered consciousness for 2 days, 1 episode of fever and vomiting. On presentation, her vital signs were heart rate of 64 beats per minute, blood pressure reading of 80/40 mmhg, spo2 of 80%, and gcs–3/15. Her ABG showed pco2 of 79mmhg and was intubated for respiratory failure and started on inotropic infusion for low BP. On examination, patient was found to be morbidly obese, had macroglossia, and per orbital edema. Lab investigation showed thyroid stimulating hormone of 31.76 µIU/ml. The patient was diagnosed with myxoedema coma and was started on higher dose of thyroid supplements and IV steroids. Over the next week the patient regained consciousness and improved dramatically.