Myxedema Coma (माइक्सेडिमा कोमा) एक life-threatening endocrine emergency है जो severe hypothyroidism के कारण होता है।
- यह स्थिति अक्सर untreated hypothyroidism या stress, infection, surgery के बाद triggered होती है।
- Rare लेकिन mortality rate high है, इसलिए early recognition और ICU management जरूरी है।
- Common in elderly women, लेकिन किसी भी age में हो सकता है।
Myxedema Coma क्या है (What is Myxedema Coma)
- Extreme manifestation of thyroid hormone deficiency
- Leads to decreased metabolic rate, hypothermia, bradycardia, hypotension, and altered mental status
- Characterized by myxedema (facial puffiness, edema), hypothermia, and coma
- Usually precipitated by infection, trauma, drugs (sedatives, anesthetics)
Myxedema Coma कारण (Causes of Myxedema Coma)
1. Primary Hypothyroidism
- Hashimoto’s thyroiditis
- Iodine deficiency
- Post-thyroidectomy or radioiodine therapy
2. Secondary Hypothyroidism
- Pituitary or hypothalamic dysfunction
3. Precipitating Factors
- Infection (pneumonia, urinary tract infection)
- Trauma, burns, or surgery
- Medications: sedatives, opioids, amiodarone
- Cold exposure
Myxedema Coma लक्षण (Symptoms of Myxedema Coma)
Early Signs:
- Fatigue, lethargy
- Cold intolerance
- Constipation
- Weight gain
Severe / Coma Stage:
- Altered mental status: confusion → stupor → coma
- Hypothermia (body temperature <35°C)
- Bradycardia (slow heart rate)
- Hypotension (low blood pressure)
- Facial puffiness, periorbital edema
- Dry, coarse skin, hair loss
- Hoarseness, thick tongue
- Hypoventilation (slow breathing)
Myxedema coma is a medical emergency।
Myxedema Coma कैसे पहचाने (Diagnosis of Myxedema Coma)
- Clinical Examination – coma, hypothermia, bradycardia, edema
- Laboratory Tests
- Low T4 (free thyroxine)
- Elevated TSH (primary hypothyroidism)
- Hyponatremia, hypoglycemia
- Electrolytes and Blood Gas – check metabolic derangements
- ECG – bradycardia, low voltage complexes
- Identify Precipitating Factor – infection, trauma, medications
Early recognition crucial for life-saving treatment।
Myxedema Coma इलाज (Treatment of Myxedema Coma)
1. Thyroid Hormone Replacement
- IV Levothyroxine (T4) initially
- Sometimes IV Liothyronine (T3) in severe cases
2. Supportive Therapy
- ICU care for hemodynamic support
- Mechanical ventilation if hypoventilation
- Warm blankets, avoid rapid rewarming
- Treat hyponatremia, hypoglycemia
3. Treat Precipitating Cause
- IV antibiotics for infection
- Stop offending drugs
4. Monitoring
- Continuous ECG, BP, temperature
- Serial thyroid function tests
- Monitor for complications like heart failure
Rapid initiation of therapy improves survival significantly।
रोकथाम (Prevention)
- Adequate thyroid hormone replacement in hypothyroid patients
- Regular monitoring of TSH and T4 levels
- Prompt treatment of infections and other stressors
- Avoid medications that suppress thyroid function in hypothyroid patients
सावधानियाँ (Precautions)
- Early recognition of hypothyroid patients at risk
- Avoid cold exposure in untreated hypothyroid individuals
- Monitor for cardiac complications during thyroid hormone replacement
- ICU management for severe cases
FAQs (अक्सर पूछे जाने वाले प्रश्न)
Q1. Myxedema coma कितनी जल्दी fatal हो सकता है?
Untreated cases में hours to days में mortality high (up to 50–60%) होती है।
Q2. क्या यह सिर्फ elderly में होता है?
सबसे common elderly women में, लेकिन किसी भी age में हो सकता है।
Q3. क्या hypothyroidism से बचाव possible है?
हाँ, regular monitoring और timely thyroid hormone replacement से।
Q4. Hospital में इलाज के बिना क्या recovery possible है?
नहीं, ICU care और IV therapy essential हैं।
निष्कर्ष (Conclusion)
Myxedema Coma (माइक्सेडिमा कोमा) एक life-threatening complication है, जो severe hypothyroidism के कारण होती है।
Early recognition, ICU management, thyroid hormone replacement, और precipitating cause का treatment जीवन बचाने में critical हैं।
अगर किसी में hypothyroid symptoms के साथ lethargy, hypothermia या altered mental status दिखाई दे, तो तुरंत emergency medical care जरूरी है।