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February 1, 1965

Myxedema Coma

JAMA. 1965;191(5):423. doi:10.1001/jama.1965.03080050069041

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Myxedema coma, first reported in 1880 but not with frequency until 1953, remains poorly understood today. Progression from hypothyroidism to myxedema and finally to coma, while generally insidious, may be hastened by complicating illness or clouded by overlying myxedema psychosis. When coma occurs it is an urgent event requiring expert handling, but established guidelines are not generally available. Physicians need a book that will interpret the scattered literature, present the basic concepts of diagnosis and management, and clarify the pathophysiology.

The authors base their review on 106 previously reported cases, and supplement this with descriptions of four new patients. Problems of hypothermia, carbon dioxide narcosis, fluid and electrolyte disturbances, and cardiac arrythmias are adequately presented, and these discussions are followed by terse accounts of differential diagnosis, precipitating factors, and complications. One fourth of the text is devoted to management, with emphasis on the high mortality rate and the certain hazards

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