Myxedema: what it is, characteristics and associated symptoms.

Cases of myxedema indicate the presence of a thyroid disorder. Let's see how it arises.

Myxedema is a complicated medical condition that is the result of hypothyroidism not being properly diagnosed and treated.

This medical problem can be quite problematic for the sufferer's life, as it involves serious dermatological changes, fluid retention and some cognitive problems.

It can be aggravated, giving rise to myxedema crisesIt can be aggravated, leading to myxedema crises, in which its consequences can be fatal, leading to coma and death. Next we will discover more symptoms of this disease, what are its possible causes and how it is treated.

What is myxedema?

Myxedema is another term for severely advanced hypothyroidism.. Hypothyroidism occurs when the thyroid gland does not produce enough thyroid hormone. The thyroid is a gland that releases hormones that are responsible for regulating energy levels and the overall functioning of the body. In case of poor production of these hormones, several of the body's functions are affected.

Very advanced hypothyroidism can cause a myxedema crisis, which is a very serious medical condition requiring urgent intervention.

The word myxedema is used, above all, to refer to the dermatological symptoms of advanced hypothyroidism and the associated clinical picture.. Among the main skin changes that can occur as a consequence of a malfunctioning thyroid gland we have: Swelling of the face, including lips, eyelids and tongue.

Swelling and thickening of the skin anywhere on the body, especially on the lower legs.

Symptoms

In addition to the skin changes we have already mentioned, other symptoms can be associated with myxedema.

• Low blood pressure
• Low heart rate
• Sparse, brittle hair
• Goiter (enlargement of the thyroid gland)
• Low energy and lethargy
• Weight gain
• Weakness
• Intolerance to cold
• Constipation
• Depressive symptoms
• Skin thickening
• Rough skin
• Negative Godet's sign.
• Change in facial appearance
• Thick nose.
• Gelatinous infiltrations in the subcutaneous tissue.
• Slow speech
• Mental sluggishness
• Lethargy
• Mental problems
• Pale yellow dry skin
• Edematous subcutaneous tissues
• Weight gain
• Constipation
• Brittle and sparse hair
• Bald patches
• Muscle aches and pains
• Decreased hearing and deafness
• Carpal tunnel syndrome

Myxedema crisis

Myxedema crisis, also called myxedema coma, is an urgent medical condition that occurs when the body cannot tolerate the changes associated with severe hypothyroidism. an urgent medical condition that occurs when the body cannot tolerate the changes associated with severe hypothyroidism.. The body is decompensated, with very abnormal levels of different substances that hinder the proper functioning of the body.

• Respiratory depression
• Low blood sodium levels
• Hypothermia: body temperature below 35º.
• Confusion and worrying mental slowness.
• Shock
• Low blood oxygen levels
• High blood carbon dioxide levels
• Coma
• Seizures

Myxedema crisis May cause death due to complications from infection, hemorrhage, or respiratory failure. It is more common in women (80%) and people over 60 years of age, appearing mainly in winter. It can occur during pregnancy as well.

Causes

As we have seen, hypothyroidism occurs when the thyroid gland does not function properly.. There are several reasons that can explain why the thyroid gland fails or is working less than it should, among which we can highlight:

• Autoimmune disease, including Hashimoto's disease.
• Surgical removal of the thyroid gland
• Radiation therapy
• Certain drugs, such as lithium and amiodarone (Pacerone)
• Iodine deficiency or excess
• Pregnancy
• Immune system medications, such as those used for cancer

The dermatological problems of myxedema and the crisis associated with this medical problem usually occur When severe hypothyroidism has not been properly diagnosed and treated.. It can also occur as a consequence of abandoning thyroid medication, causing this clinical picture to occur.

One of the biological explanations that have been given to explain myxedema has to do with deposits of carbohydrate chains, specifically mucopolysaccharides.. These substances accumulate in the skin and damage it. They also explain the swelling since they are substances that attract water, causing it to accumulate in the skin.

As for the myxedema crisis, which as we have mentioned is much more serious, this tends to occur more in the winter months and can be triggered by the following factors:

• Stopping treatment for hypothyroidism.
• Suffering a heart attack or stroke
• Infection
• Trauma
• Use of central nervous system suppressing drugs
• Exposure to cold
• Stress

How is myxedema diagnosed?

Myxedema is a medical condition that, when it occurs, does not go unnoticed. Whether in the form of a crisis or in its less urgent form, the physician will quickly diagnose that you are suffering from myxedema, and proceed to intervene. To confirm the diagnosis, blood tests can be performed to look at the levels of sodium, carbohydrates, oxygen and carbon dioxide..

In myxedema it usually happens that the pituitary gland increases the production of thyroid stimulating hormone when the thyroid gland is not working sufficiently. The thyroid gland test is accompanied by a test for thyroxine (T4), a hormone which is produced directly in the thyroid. If there is high production of thyroid stimulating hormone but low production of thyroxine, it is a biological indicator of hypothyroidism.

As for myxedema crisis, given the severity of the situation, you should proceed quickly and confirm the diagnosis as soon as possible. This is why medical personnel will focus on the following symptoms to confirm or reject the diagnosis and intervene urgently:

• Dry skin
• Sparse hair
• Hypothermia
• Swelling of the face and legs
• Goiter
• Possible scarring from a thyroidectomy
• Low Blood Pressure and heart rate
• Confusion
• Decreased breathing

Complications of myxedema

The thyroid gland is very important for the proper functioning of the body, especially metabolism.especially the metabolism. In very advanced hypothyroidism it usually happens that the metabolism is very slowed down, affecting the use of oxygen. This has a very negative effect on all organ processes and body systems, which can lead to the following medical complications if myxedema is left untreated.

• Hypothermia
• Swelling and fluid retention
• Low drug metabolism and risk of accumulation
• Pregnancy problems, such as miscarriage, preeclampsia (chronic high blood pressure), premature birth and birth defects
• Heart failure
• Kidney problems
• Depression
• Coma
• Death

How is myxedema treated?

To avoid myxedema, hypothyroidism must be treated first, since it is that medical problem that causes it.since it is this medical problem that causes myxedema. Treatment focuses on administering a synthetic version of T4 hormone called levothyroxine (Levothroid, Levoxyl).

Once administered, T4 levels are restored, making symptoms easier.making symptoms easier to control. While it may take weeks for acceptable improvement, this intervention is very effective. However, the patient will most likely have to take the drug for the rest of his or her life.

For myxedema crises, treatment is urgent. The patient will receive intensive care and the first therapeutic option is to give thyroid hormone as replacement therapy, administered intravenously. thyroid hormone as replacement therapy, administered intravenously.. Some blood tests will also be performed to confirm the levels of different substances.

Prevention is preferable to treatment because, in case of crisis, even receiving emergency treatment, mortality is quite high, between 25 and 60%.

Bibliographic references:

• Berger, William D. James, Dirk M. Elston, Timothy G. (2011). St. Andrews' Diseases of the skin : clinical dermatology (11th ed.). [London]: Saunders/ Elsevier. ISBN 978-1-4377-0314-6.
• McConahey, W. M. (March 1978). Diagnosing and treating myxedema and myxedema coma. Geriatrics. 33 (3): 61-66. ISSN 0016-867X. PMID 624451
• Lindholm, J.; Laurberg, P. (2011). Hypothyroidism and Thyroid Substitution: Historical Aspects. Journal of Thyroid Research. 2011: 809341. doi:10.4061/2011/809341. PMC 3134382. PMID 21760981.