Seizures and Cardiac Tamponade in Long-Standing Severe Hypothyroidism

Authors

  • May Uyking Naranjo Section of Endocrinology, Diabetes and Metabolism, Department of Medicine St. Luke’s Medical Center, Quezon City, Philippines
  • Marjorie Ramos Section of Endocrinology, Diabetes and Metabolism, Department of Medicine St. Luke’s Medical Center, Quezon City, Philippines

Abstract

We report a patient who presented with a seizure episode and concurrent clinical and echocardiographic evidence of cardiac tamponade caused by severe hypothyroidism.  The symptoms  improved following immediate tube pericardiostomy and thyroxine hormone replacement. The classic symptoms of severe hypothyroidism are now rarely seen given the wide availability of thyrotropin (TSH) assays and thyroid hormone tablets. The simultaneous occurrence of both symptoms during a single admission has not been previously reported in literature.

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References

Kwaku MP, Burman KD. Myxedema coma. J Intensive Care Med. 2007;22(4):224-31.

Wartofsky L. Myxoedema coma. Endocrinol Metab Clin N Am. 2006;35:687-98.

Rodríguez I, Fluiters E, Pérez-Méndez LF et al. Factors associated with mortality of patients with myxoedema coma: Prospective study in 11 cases treated in a single institution. J Endocrinol. 2004;180(2):347-50.

Wall CR. Myxedema coma: Diagnosis and treatment. Am Fam Phys. 2000; 62:2485-90.

Nicoloff JT, LoPresti JS. Myxedema coma: A form of decompensated hypothyroidism. Endocrinol Metab Clin North Am. 1993;22:279–90.

Chu M, Seltzer TM. Myxedema coma induced by ingestion of raw bok choy. N Engl J Med. 2010;362:1945-6.

Westphal SA. Unusual presentations of hypothyroidism. Am J Intensive Care Med. 2007;22:224.

Haupt M, Kurz A. Reversibility of dementia in hypothyroidism. J Neurol. 1993; 240:333.

Hardisty CA, Naik DR, Munro DS. Pericardial effusion in hypothyroidism. Clin Endocrinol. 1980;13:349-54.

Kabadi UM, Kumar SP. Pericardial effusion in primary hypothyroidism. Am Heart J. 1990;120:1393-5.

Braunwald E, Lorell BH. Pericardial Disease. In: Heart Disease: A Textbook of Cardiovascular Medicine, edited by Eugene Braunwald, 1465-516. Philadelphia: WB Saunders, 1992.

Hoit BD. Cardiac Tamponade. Uptodate, edited by Gersch, BJ, Hoekstra J, Downey BC. September 2009

Klein I, Mantell P, Parker M, Levey GS. Resolution of abnormal muscle enzymes in hypothyroidism. Am J Med Sci. 1980;279:159-62.

Horwitz MS, Schultz CS, Stinson EB et al. Sensitivity and specificity of echocardiographic diagnosis of pericardial effusion. Circulation. 1974;50:239-47.

Fujiyoshi A, Yamamoto T. Two cases of myxedema coma successfully treated with low-dose thyroid hormone replacement. Journal of Japanese Association for Acute Medicine. 2000;11:22-6.

Rechad M, Cassim, Trentini AP et al. Pericardial effusion with cardiac tamponade as a form of presentation of primary hypothyroidism. Archives of Brazil Cardiology. 2002;78:583-5.

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Published

2014-05-28

How to Cite

Naranjo, M. U., & Ramos, M. (2014). Seizures and Cardiac Tamponade in Long-Standing Severe Hypothyroidism. Journal of the ASEAN Federation of Endocrine Societies, 26(2), 175. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/93

Issue

Vol. 26 No. 2 (2011): November Issue

Section

Case Reports

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