Precipitating Factors and Differential Diagnosis of Myxoedema Coma

In this article, we will discuss the Precipitating Factors and Differential Diagnosis of Myxoedema Coma. So, let’s get started.

Precipitating Factors

The factors that push the patient of hypothyroidism into myxoedema coma are given below:

  • Infection, e.g. pneumonia
  • Exposure to cold
  • Hypoventilation
  • Hypoglycemia
  • Dilutional hyponatremia
  • Trauma
  • GI bleeding
  • Stroke (CVA)
  • CNS depressants, e.g. tranquillisers, sedatives and antidepressants
  • Cardiovascular disease (e.g. CHF), myocardial infarction
  • Respiratory disease (infection, COPD)

Hypoventilation leading to hypoxia and hypercapnia plays a major role in pathogenesis. Hypoglycemia and dilutional hyponatremia also contribute to the development of myxoedema coma.

Differential Diagnosis

The conditions which are associated with coma and hypothermia may mimic myxoedema coma. These include:

1. Brainstem infarction in older persons may lead to both coma and hypothermia

2. Hypothermia due to any cause and renal failure may itself induce physiological changes simulating myxoedema such as delayed relaxation of deep tendon reflexes. Coma is due to hypothermia and renal failure.

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