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Quality in Sport

Can one die because of Hashimoto’s disease? – a clinical review of diagnosis, clinical features and treatment of myxedema coma
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  • Can one die because of Hashimoto’s disease? – a clinical review of diagnosis, clinical features and treatment of myxedema coma
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  4. Medical Sciences

Can one die because of Hashimoto’s disease? – a clinical review of diagnosis, clinical features and treatment of myxedema coma

Authors

  • Karol Bochyński 4th Clinical University Hospital in Lublin ul. Kazimierza Jaczewskiego 8, 20-954 Lublin, Poland https://orcid.org/0009-0003-8309-2800
  • Michał Dacka 1 Military Clinical Hospital in Lublin, al. Racławickie 23, 20-049 Lublin, Poland https://orcid.org/0009-0005-8783-6517
  • Kamila Giżewska 1 Military Clinical Hospital in Lublin, al. Racławickie 23, 20-049 Lublin, Poland https://orcid.org/0000-0003-1682-180X
  • Konrad Białogłowski University Clinical Hospital No. 1 in Lublin, ul. Stanisława Staszica 16, 20-081 Lublin, Poland https://orcid.org/0009-0001-1705-254X
  • Paulina Dąbrowska Province Specialist Hospital named after Stefan Cardinal Wyszyński in Lublin al. Kraśnicka 100, 20-718 Lublin, Poland https://orcid.org/0009-0004-6439-3357
  • Michał Żuber 4th Clinical University Hospital in Lublin ul. Kazimierza Jaczewskiego 8, 20-954 Lublin, Poland https://orcid.org/0009-0000-2538-8556
  • Katarzyna Ciuba Province Specialist Hospital named after Stefan Cardinal Wyszyński in Lublin al. Kraśnicka 100, 20-718 Lublin, Poland https://orcid.org/0009-0007-8347-3282
  • Katarzyna Molenda 1 Military Clinical Hospital in Lublin, al. Racławickie 23, 20-049 Lublin, Poland https://orcid.org/0009-0005-1928-4220
  • Filip Borodziuk 1 Military Clinical Hospital in Lublin, al. Racławickie 23, 20-049 Lublin, Poland https://orcid.org/0009-0000-0394-1816
  • Barbara Borodziuk 1 Military Clinical Hospital in Lublin, al. Racławickie 23, 20-049 Lublin, Poland https://orcid.org/0009-0009-2716-6653

DOI:

https://doi.org/10.12775/QS.2024.18.53211

Keywords

diet Hashimoto, endocrine diseases, Endocrine System Diseases

Abstract

Introduction and Purpose

Hashimoto’s disease is the most common reason of hypothyroidism. Usually, it is easy to recognize and treat. However, under certain circumstances, it may develop into the most severe manifestation of hypothyroidism known as myxedema and can lead to a threat to the patient's life.

Hypothyroid crisis, or myxedema coma, is an extremely rare but fatal medical emergency. If the condition is not promptly diagnosed and treated, the mortality rate is high as 50%. Even with immediate recognition and appropriate medical intervention, mortality rates of up to 25% have been observed. 

This article aim is to enhance medical community awareness by examining features of myxedema, prevalence, and associated risk factors, contributing to improved clinical management. Emphasizing tailored treatment strategies for hypothyroidism, coexisting illnesses, and metabolic decompensation, it ultimately seeks to enhance outcomes for patients with severe hypothyroidism.

Material and methods

Conducting a systematic review of medical articles from 1997 to 2024 using PubMed, this study analyzed articles with keywords such myxedema coma, hypothyroidism, Hashimoto’s thyroiditis. Inclusion of pertinent articles ensured a comprehensive exploration of myxedema coma literature during the specified time frame.

Summary

Myxedema coma is a thyroid emergency linked to hypothyroidism. This review sheds light on the etiology of myxedema, clinical manifestations, diagnostic criteria and comprehensive treatment options. In order to reduce mortality in patients, there is a need to increase knowledge of the risk of development, clinical features and management not only for emergency physicians but also for physicians of all specialties..

References

Dubbs SB, Spangler R. Hypothyroidism: causes, killers, and life-saving treatments. Emerg Med Clin North Am. 2014 May;32(2):303-17. doi: 10.1016/j.emc.2013.12.003. Epub 2014 Mar 6. PMID: 24766934.

Chen YJ, Hou SK, How CK, Chern CH, Lo HC, Yen DH, Huang CI, Lee CH. Diagnosis of unrecognized primary overt hypothyroidism in the ED. Am J Emerg Med. 2010 Oct;28(8):866-70. doi: 10.1016/j.ajem.2009.04.024. Epub 2010 Mar 25. PMID: 20887907.

Bridwell RE, Willis GC, Gottlieb M, Koyfman A, Long B. Decompensated hypothyroidism: A review for the emergency clinician. Am J Emerg Med. 2021 Jan;39:207-212. doi: 10.1016/j.ajem.2020.09.062. Epub 2020 Sep 30. PMID: 33039222.

Brady J, Cannupp A, Myers J, Jnah AJ. Congenital Hypothyroidism. Neonatal Netw. 2021 Nov 1;40(6):377-385. doi: 10.1891/11-T-699. PMID: 34845088.

Klosinska M, Kaczynska A, Ben-Skowronek I. Congenital Hypothyroidism in Preterm Newborns - The Challenges of Diagnostics and Treatment: A Review. Front Endocrinol (Lausanne). 2022 Mar 18;13:860862. doi: 10.3389/fendo.2022.860862. PMID: 35370986; PMCID: PMC8972126.

Feldt-Rasmussen U, Effraimidis G, Klose M. The hypothalamus-pituitary-thyroid (HPT)-axis and its role in physiology and pathophysiology of other hypothalamus-pituitary functions. Mol Cell Endocrinol. 2021 Apr 5;525:111173. doi: 10.1016/j.mce.2021.111173. Epub 2021 Feb 4. PMID: 33549603.

Leng O, Razvi S. Hypothyroidism in the older population. Thyroid Res. 2019 Feb 8;12:2. doi: 10.1186/s13044-019-0063-3. PMID: 30774717; PMCID: PMC6367787.

Khandelwal D, Tandon N. Overt and subclinical hypothyroidism: who to treat and how. Drugs. 2012 Jan 1;72(1):17-33. doi: 10.2165/11598070-000000000-00000. PMID: 22191793.

Chaker L, Bianco AC, Jonklaas J, Peeters RP. Hypothyroidism. Lancet. 2017 Sep 23;390(10101):1550-1562. doi: 10.1016/S0140-6736(17)30703-1. Epub 2017 Mar 20. PMID: 28336049; PMCID: PMC6619426.

Concolino P, Costella A, Paragliola RM. Mutational Landscape of Resistance to Thyroid Hormone Beta (RTHβ). Mol Diagn Ther. 2019 Jun;23(3):353-368. doi: 10.1007/s40291-019-00399-w. PMID: 30976996.

Persani L. Clinical review: Central hypothyroidism: pathogenic, diagnostic, and therapeutic challenges. J Clin Endocrinol Metab. 2012 Sep;97(9):3068-78. doi: 10.1210/jc.2012-1616. Epub 2012 Jul 31. PMID: 22851492.

Nakajima Y, Yamada M. [Subclinical thyroid disease]. Nihon Rinsho. 2012 Nov;70(11):1865-71. Japanese. PMID: 23214054.

Roberts CG, Ladenson PW. Hypothyroidism. Lancet. 2004 Mar 6;363(9411):793-803. doi: 10.1016/S0140-6736(04)15696-1. PMID: 15016491.

Mincer DL, Jialal I. Hashimoto Thyroiditis. 2023 Jul 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 29083758.

Klubo-Gwiezdzinska J, Wartofsky L. Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment. Pol Arch Intern Med. 2022 Mar 30;132(3):16222. doi: 10.20452/pamw.16222. Epub 2022 Mar 3. PMID: 35243857; PMCID: PMC9478900.

Ueda K, Kiyota A, Tsuchida M, Okazaki M, Ozaki N. Successful treatment of myxedema coma with a combination of levothyroxine and liothyronine. Endocr J. 2019 May 28;66(5):469-474. doi: 10.1507/endocrj.EJ18-0469. Epub 2019 Mar 8. PMID: 30853666.

Wartofsky L. Myxedema coma. Endocrinol Metab Clin North Am. 2006 Dec;35(4):687-98, vii-viii. doi: 10.1016/j.ecl.2006.09.003. PMID: 17127141.

Wall CR. Myxedema coma: diagnosis and treatment. Am Fam Physician. 2000 Dec 1;62(11):2485-90. PMID: 11130234.

Li Z, Qiu Y, Fei Y, Xing Z, Zhu J, Su A. Prevalence of and risk factors for hypothyroidism after hemithyroidectomy: a systematic review and meta-analysis. Endocrine. 2020 Nov;70(2):243-255. doi: 10.1007/s12020-020-02410-5. Epub 2020 Jul 7. PMID: 32638212.

Alaie M, Tramutola A, Mukamal D. A Case Report on Methimazole-Induced Severe Hypothyroidism. Cureus. 2022 Jan 17;14(1):e21339. doi: 10.7759/cureus.21339. PMID: 35186597; PMCID: PMC8849643

Yamada S, Horiguchi K, Akuzawa M, Sakamaki K, Yamada E, Ozawa A, Kobayashi I, Shimomura Y, Okamoto Y, Andou T, Andou Y, Yamada M. The Impact of Age- and Sex-Specific Reference Ranges for Serum Thyrotropin and Free Thyroxine on the Diagnosis of Subclinical Thyroid Dysfunction: A Multicenter Study from Japan. Thyroid. 2023 Apr;33(4):428-439. doi: 10.1089/thy.2022.0567. Epub 2023 Mar 22. Erratum in: Thyroid. 2023 Sep;33(9):1134. PMID: 36772798; PMCID: PMC10620437.

Arlot S, Debussche X, Lalau JD, Mesmacque A, Tolani M, Quichaud J, Fournier A. Myxoedema coma: response of thyroid hormones with oral and intravenous high-dose L-thyroxine treatment. Intensive Care Med. 1991;17(1):16-8. doi: 10.1007/BF01708403. PMID: 2037720.

Caturegli P, De Remigis A, Chuang K, Dembele M, Iwama A, Iwama S. Hashimoto's thyroiditis: celebrating the centennial through the lens of the Johns Hopkins hospital surgical pathology records. Thyroid. 2013 Feb;23(2):142-50. doi: 10.1089/thy.2012.0554. PMID: 23151083; PMCID: PMC3569966.

Ralli M, Angeletti D, Fiore M, D'Aguanno V, Lambiase A, Artico M, de Vincentiis M, Greco A. Hashimoto's thyroiditis: An update on pathogenic mechanisms, diagnostic protocols, therapeutic strategies, and potential malignant transformation. Autoimmun Rev. 2020 Oct;19(10):102649. doi: 10.1016/j.autrev.2020.102649. Epub 2020 Aug 15. PMID: 32805423.

Wu G, Zou D, Cai H, Liu Y. Ultrasonography in the diagnosis of Hashimoto's thyroiditis. Front Biosci (Landmark Ed). 2016 Jun 1;21(5):1006-12. doi: 10.2741/4437. PMID: 27100487.

Hu X, Chen Y, Shen Y, Tian R, Sheng Y, Que H. Global prevalence and epidemiological trends of Hashimoto's thyroiditis in adults: A systematic review and meta-analysis. Front Public Health. 2022 Oct 13;10:1020709. doi: 10.3389/fpubh.2022.1020709. PMID: 36311599; PMCID: PMC9608544.

Bakkour A, Zakkor MD, Taha Khairy L, Horo R, Mohammed Sharif Ahmed E, Alhussein H. Autoimmune polyglandular syndrome type 2: A case report. Ann Med Surg (Lond). 2022 May 16;78:103742. doi: 10.1016/j.amsu.2022.103742. PMID: 35600201; PMCID: PMC9121250.

Weber Pasa M, Selbach Scheffel R, Borsatto Zanella A, Maia AL, Dora JM. Consumptive Hypothyroidism: Case Report of Hepatic Hemangioendotheliomas Successfully Treated with Vincristine and Systematic Review of the Syndrome. Eur Thyroid J. 2017 Nov;6(6):321-327. doi: 10.1159/000481253. Epub 2017 Oct 13. PMID: 29234626; PMCID: PMC5704697.

Huang SA, Tu HM, Harney JW, Venihaki M, Butte AJ, Kozakewich HP, Fishman SJ, Larsen PR. Severe hypothyroidism caused by type 3 iodothyronine deiodinase in infantile hemangiomas. N Engl J Med. 2000 Jul 20;343(3):185-9. doi: 10.1056/NEJM200007203430305. PMID: 10900278.

Wiersinga WM. Myxedema and Coma (Severe Hypothyroidism). 2018 Apr 25. In: Feingold KR, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, de Herder WW, Dhatariya K, Dungan K, Hofland J, Kalra S, Kaltsas G, Kapoor N, Koch C, Kopp P, Korbonits M, Kovacs CS, Kuohung W, Laferrère B, Levy M, McGee EA, McLachlan R, New M, Purnell J, Sahay R, Shah AS, Singer F, Sperling MA, Stratakis CA, Trence DL, Wilson DP, editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000–. PMID: 25905238.

Yamamoto H, Hongo T, Nojima T, Obara T, Kosaki Y, Ageta K, Tsukahara K, Yumoto T, Nakao A, Naito H. Successfully treated case of severe hypothermia secondary to myxedema coma. Acute Med Surg. 2023 Mar 14;10(1):e828. doi: 10.1002/ams2.828. PMID: 36936740; PMCID: PMC10014422.

Dixit NM, Truong KP, Rabadia SV, Li D, Srivastava PK, Mosaferi T, Calfon Press MA, Donangelo I, Kelesidis T. Sudden Cardiac Arrest in a Patient With Myxedema Coma and COVID-19. J Endocr Soc. 2020 Aug 28;4(10):bvaa130. doi: 10.1210/jendso/bvaa130. PMID: 32984743; PMCID: PMC7499619.

Popoveniuc G, Chandra T, Sud A, Sharma M, Blackman MR, Burman KD, Mete M, Desale S, Wartofsky L. A diagnostic scoring system for myxedema coma. Endocr Pract. 2014 Aug;20(8):808-17. doi: 10.4158/EP13460.OR. PMID: 24518183.

Lee CH, Wira CR. Severe angioedema in myxedema coma: a difficult airway in a rare endocrine emergency. Am J Emerg Med. 2009 Oct;27(8):1021.e1-2. doi: 10.1016/j.ajem.2008.12.027. PMID: 19857436.

Sokołowski G, Motyka M, Gilis-Januszewska A, Stefańska A, Hubalewska-Dydejczyk A. Liquid levothyroxine in the treatment of myxoedema coma. Endokrynol Pol. 2023;74(2):215-216. doi: 10.5603/EP.a2023.0017. Epub 2023 Apr 11. PMID: 37039496.

Gadaen RJ, Tummers-de Lind van Wijngaarden RF. Hypothyroid Crisis: Oral or Intravenous Treatment? A Report of Two Cases. Eur J Case Rep Intern Med. 2021 Sep 10;8(9):002752. doi: 10.12890/2021_002752. PMID: 34671573; PMCID: PMC8523370.

Brigić A, Hasanović M, Pajević I, Aljukić N, Hamidović J, Jakovljević M. Principles of Hippocratic Medicine from the Perspective of Modern Medicine. Psychiatr Danub. 2021 Spring-Summer;33(Suppl 4):1210-1217. PMID: 35354189.

Elshimy G, Chippa V, Correa R. Myxedema. 2023 Aug 14. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 31424777.

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Published

2024-07-25

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BOCHYŃSKI, Karol, DACKA, Michał, GIŻEWSKA, Kamila, BIAŁOGŁOWSKI, Konrad, DĄBROWSKA, Paulina, ŻUBER, Michał, CIUBA, Katarzyna, MOLENDA, Katarzyna, BORODZIUK, Filip and BORODZIUK, Barbara. Can one die because of Hashimoto’s disease? – a clinical review of diagnosis, clinical features and treatment of myxedema coma. Quality in Sport. Online. 25 July 2024. Vol. 18, p. 53211. [Accessed 15 June 2025]. DOI 10.12775/QS.2024.18.53211.
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Copyright (c) 2024 Karol Bochyński, Michał Dacka, Kamila Giżewska, Konrad Białogłowski, Paulina Dąbrowska, Michał Żuber, Katarzyna Ciuba, Katarzyna Molenda, Filip Borodziuk, Barbara Borodziuk

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