Myxoedema Coma Precipitated by Diabetic Ketoacidosis and Septic Shock: a Case Report

Abstract

Myxoedema coma (or myxoedema crisis) is a severe and potentially fatal form of decompensated hypothyroidism with an underlying cause. A low index of suspicion and a search for triggering factors should be the first step in dealing with the condition at an early stage. Myxoedema coma should be suspected in patients who present with hypothermia, altered mental status, and coma, even if hypothyroidism has not previously been recognized. The symptoms of hypothyroidism decompensation may mistakenly be attributed to its precipitating factors, which may include sepsis, cardiac failure, myocardial infarction, cerebrovascular accident, anaesthetic, sedatives, antidepressant medications, or metabolic and electrolyte abnormalities. Here, we present a case of myxoedema coma with two major underlying precipitating causes: septic shock and diabetic ketoacidosis.