Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2025
Thyroid Emergencies: A Narrative Review.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kruithoff Margaret L, Gigliotti Benjamin J
Аннотация
INTRODUCTION: Myxedema coma and thyroid storm are rare thyroid emergencies associated with considerable mortality and morbidity.
RESULTS: Myxedema coma is a state of decompensated hypothyroidism with widespread multi-organ dysfunction, including impaired consciousness, mixed respiratory failure, and hypothermia. Thyroid storm is the extreme state of thyrotoxicosis occurring when a patient's metabolic, thermoregulatory, and cardiovascular compensatory mechanisms are surpassed; clinical features include hyperthermia, neuropsychiatric symptoms, and tachyarrhythmias. Thyroid emergencies usually result from a precipitating event or trigger transforming a previously compensated hypothyroid or thyrotoxic state. Supportive care for the cardiovascular, respiratory, and thermoregulatory manifestations, as well as possible intercurrent illness or adrenal insufficiency, plays a lead role in the management. For myxedema coma, treatment typically includes high-dose levothyroxine with the addition of liothyronine for critically ill patients. Management of thyroid storm is multipronged and stepwise, consisting of first-line thionamide and beta-adrenergic receptor antagonist therapy, followed by inorganic iodine, cholestyramine, plasmapheresis, or emergent thyroidectomy in appropriate severely ill patients.
CONCLUSIONS: This review provides an updated narrative overview of the diagnosis and management of myxedema coma and thyroid storm.
RESULTS: Myxedema coma is a state of decompensated hypothyroidism with widespread multi-organ dysfunction, including impaired consciousness, mixed respiratory failure, and hypothermia. Thyroid storm is the extreme state of thyrotoxicosis occurring when a patient's metabolic, thermoregulatory, and cardiovascular compensatory mechanisms are surpassed; clinical features include hyperthermia, neuropsychiatric symptoms, and tachyarrhythmias. Thyroid emergencies usually result from a precipitating event or trigger transforming a previously compensated hypothyroid or thyrotoxic state. Supportive care for the cardiovascular, respiratory, and thermoregulatory manifestations, as well as possible intercurrent illness or adrenal insufficiency, plays a lead role in the management. For myxedema coma, treatment typically includes high-dose levothyroxine with the addition of liothyronine for critically ill patients. Management of thyroid storm is multipronged and stepwise, consisting of first-line thionamide and beta-adrenergic receptor antagonist therapy, followed by inorganic iodine, cholestyramine, plasmapheresis, or emergent thyroidectomy in appropriate severely ill patients.
CONCLUSIONS: This review provides an updated narrative overview of the diagnosis and management of myxedema coma and thyroid storm.