Alan Farwell

Are you sure the patient has myxedema coma? Clinical Features of Myxedema Coma Myxedema coma is a rare syndrome that represents the extreme expression of severe, longstanding hypothyroidism. It is a medical emergency and, even with early diagnosis and treatment, the mortality can be as high as 60%. The name is somewhat a misnomer, as…

Are you sure the patient has thyroid storm? Thyroid storm (also known as hyperthyroid crisis, thyroid crisis, or thyrotoxic crisis) is a rare, life-threatening complication of thyrotoxicosis, which is usually precipitated by an intercurrent medical problem. The incidence of thyroid storm was once relatively high because of a liberal definition of the condition. For example,…

Are you sure the patient has nonthyroidal illness? Critical illness causes multiple nonspecific alterations in thyroid hormone concentrations that relate to the severity of the illness in patients who have no intrinsic thyroid disease. There is an ongoing debate whether such alterations are a physiologic adaptation or a pathologic perturbation. Due to the complexity of…

Sick Euthyroid Syndrome Non-thyroidal illness syndrome 1. Description of the problem What every clinician needs to know Critical illness causes multiple nonspecific alterations in thyroid hormone concentrations in patients who have no intrinsic thyroid disease that relate to the severity of the illness. There is an ongoing debate whether such alterations are a physiologic adaptation…

1. Description of the problem What every clinician needs to know Whenever possible, thyroid surgery should be performed by an experienced, high-volume surgeon to minimize complications. Chronic complications include hypothyroidism (which is the expected result of most thyroid surgery) and hypoparathyroidism. In the hands of an experienced, high-volume surgeon, the incidence of acute complications and…

Thyroid Storm Also known as: Hyperthyroid crisis, thyroid crisis, thyrotoxic crisis 1. Description of the problem What every clinician needs to know Thyroid storm is a rare, life-threatening complication of thyrotoxicosis, which is usually precipitated by an intercurrent medical problem.Related Content Hyperthyroidism is the most common cause of thyrotoxicosis leading to thyroid storm. While the…

Also known as: Myxedema coma Related conditions: Hypothyroid crisis, myxedema crisis 1. Description of the problem What every clinician needs to know Myxedema coma is a rare syndrome that represents the extreme expression of severe, long-standing hypothyroidism. It is a medical emergency and, even with early diagnosis and treatment, the mortality can be as high…