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January 1964

Treatment of Myxedema Coma With Intravenous Thyroxine

Arch Intern Med. 1964;113(1):89-96. doi:10.1001/archinte.1964.00280070091015

Although coma as a terminal manifestation of myxedema was first described in 1879, it received little further emphasis until the last decade. During this period 51 cases were reported in English-language journals.1-33 Despite the increased interest in this complication, more than 80% of patients died during treatment in the period 1953-1961. The discovery of triiodothyronine and the characterization of its potent and rapid action in man held forth the hope that a useful agent was now available for treatment of myxedema coma. Although repeated small doses of triiodothyronine failed in the treatment of three of four patients with terminal myxedema who were treated in this way by Nickerson, Hill, McNeil, and Barker in 1960, the following year Catz and Russell reported the survival of seven of 12 cases of myxedema coma after systematic use of triiodothyronine by either the oral or the intravenous route.24

That the appalling mortality