Omoniyi Elizabeth Jasola, Robbins Richard J
Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Houston Methodist Hospital, Houston, TX, USA.
Weill Cornell Medical College, New York, NY, USA.
Case Rep Endocrinol. 2022 Apr 28;2022:1591616. doi: 10.1155/2022/1591616. eCollection 2022.
Myxedema coma is a rare life-threatening presentation of severe hypothyroidism associated with a high mortality rate. Although most cases are due to primary thyroid failure, a minority have central hypothyroidism as the underlying cause. We report the case of a 69-year-old man who presented with obtundation, hypoglycemia, and hyponatremia. The patient's initial thyroid-stimulating hormone (TSH) was within normal limits. Subsequent evaluation revealed critical anterior pituitary insufficiency due to a macroprolactinoma and a diagnosis of myxedema coma after appropriate workup The finding of a normal serum TSH should not eliminate the possibility of myxedema coma.
黏液性水肿昏迷是严重甲状腺功能减退症的一种罕见的危及生命的表现形式，死亡率很高。虽然大多数病例是由于原发性甲状腺功能衰竭，但少数病例的根本原因是中枢性甲状腺功能减退。我们报告一例69岁男性患者，表现为意识模糊、低血糖和低钠血症。患者最初的促甲状腺激素（TSH）在正常范围内。后续评估发现因大泌乳素瘤导致严重的垂体前叶功能不全，经适当检查后诊断为黏液性水肿昏迷。血清TSH正常这一发现不应排除黏液性水肿昏迷的可能性。
