Laryngeal myxoedema: a literature review of an uncommon complication of hypothyroidism
A 59-year-old woman presented to the emergency department with shortness of breath. She had significant oropharyngeal swelling obstructing her upper respiratory tract. A diagnosis of laryngeal myxoedema was made, which was attributed to severe hypothyroidism. She required invasive ventilation and su...
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| Published in | BMJ case reports Vol. 14; no. 4; p. e241313 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
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BMJ Publishing Group LTD
01.04.2021
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| Abstract | A 59-year-old woman presented to the emergency department with shortness of breath. She had significant oropharyngeal swelling obstructing her upper respiratory tract. A diagnosis of laryngeal myxoedema was made, which was attributed to severe hypothyroidism. She required invasive ventilation and subsequently a tracheostomy. She was treated with levothyroxine and hydrocortisone. She completely recovered with this therapy. In this review, we will discuss similar cases and different therapeutic options. This case also highlights the fact that establishing a diagnosis of laryngeal myxoedema, a condition that can potentially have lethal outcomes and can be challenging. |
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| AbstractList | A 59-year-old woman presented to the emergency department with shortness of breath. She had significant oropharyngeal swelling obstructing her upper respiratory tract. A diagnosis of laryngeal myxoedema was made, which was attributed to severe hypothyroidism. She required invasive ventilation and subsequently a tracheostomy. She was treated with levothyroxine and hydrocortisone. She completely recovered with this therapy. In this review, we will discuss similar cases and different therapeutic options. This case also highlights the fact that establishing a diagnosis of laryngeal myxoedema, a condition that can potentially have lethal outcomes and can be challenging. A 59-year-old woman presented to the emergency department with shortness of breath. She had significant oropharyngeal swelling obstructing her upper respiratory tract. A diagnosis of laryngeal myxoedema was made, which was attributed to severe hypothyroidism. She required invasive ventilation and subsequently a tracheostomy. She was treated with levothyroxine and hydrocortisone. She completely recovered with this therapy. In this review, we will discuss similar cases and different therapeutic options. This case also highlights the fact that establishing a diagnosis of laryngeal myxoedema, a condition that can potentially have lethal outcomes and can be challenging.A 59-year-old woman presented to the emergency department with shortness of breath. She had significant oropharyngeal swelling obstructing her upper respiratory tract. A diagnosis of laryngeal myxoedema was made, which was attributed to severe hypothyroidism. She required invasive ventilation and subsequently a tracheostomy. She was treated with levothyroxine and hydrocortisone. She completely recovered with this therapy. In this review, we will discuss similar cases and different therapeutic options. This case also highlights the fact that establishing a diagnosis of laryngeal myxoedema, a condition that can potentially have lethal outcomes and can be challenging. |
| Author | Iftikhar, Mian Harris Coll, Patrick Dar, Aneeqa Yousaf Raziq, Fazal I |
| AuthorAffiliation | 1 Michigan State University , East Lansing , Michigan , USA 2 Michigan State University College of Human Medicine , East Lansing , Michigan , USA 4 St Francis Hospital , Hartford , Connecticut , USA 3 University of Connecticut , Storrs , Connecticut , USA |
| AuthorAffiliation_xml | – name: 4 St Francis Hospital , Hartford , Connecticut , USA – name: 2 Michigan State University College of Human Medicine , East Lansing , Michigan , USA – name: 1 Michigan State University , East Lansing , Michigan , USA – name: 3 University of Connecticut , Storrs , Connecticut , USA |
| Author_xml | – sequence: 1 givenname: Mian Harris surname: Iftikhar fullname: Iftikhar, Mian Harris email: Iraziq.fazal462@gmail.com organization: Michigan State University, East Lansing, Michigan, USA – sequence: 2 givenname: Fazal I surname: Raziq fullname: Raziq, Fazal I email: Iraziq.fazal462@gmail.com organization: Michigan State University College of Human Medicine, East Lansing, Michigan, USA – sequence: 3 givenname: Patrick surname: Coll fullname: Coll, Patrick email: Iraziq.fazal462@gmail.com organization: University of Connecticut, Storrs, Connecticut, USA – sequence: 4 givenname: Aneeqa Yousaf surname: Dar fullname: Dar, Aneeqa Yousaf email: Iraziq.fazal462@gmail.com organization: St Francis Hospital, Hartford, Connecticut, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33795283$$D View this record in MEDLINE/PubMed |
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| Keywords | endocrine system thyroid disease drugs and medicines general practice / family medicine ear nose and throat/otolaryngology |
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| References_xml | – volume: 50 start-page: 35 year: 1995 article-title: Adrenaline administered via a nebulizer in adult patients with upper airway obstruction publication-title: Anaesthesia doi: 10.1111/j.1365-2044.1995.tb04510.x – volume: 292 start-page: 662 year: 1975 article-title: Ventilatory control in myxedema and hypothyroidism publication-title: N Engl J Med doi: 10.1056/NEJM197503272921302 – volume: 3 start-page: e101 year: 2017 article-title: Supraglottic myxedema: two cases and a review of the literature publication-title: AACE Clinical Case Reports doi: 10.4158/EP161378.CR – volume: 19 start-page: 365 year: 1983 article-title: The clinical presentation of hypothyroid myopathy and its relationship to abnormalities in structure and function of skeletal muscle publication-title: Clin Endocrinol doi: 10.1111/j.1365-2265.1983.tb00010.x – volume: 369 start-page: 1083 year: 2007 article-title: 12-h pretreatment with methylprednisolone versus placebo for prevention of postextubation laryngeal oedema: a randomised double-blind trial publication-title: Lancet doi: 10.1016/S0140-6736(07)60526-1 – volume: 101 start-page: 491 year: 1984 article-title: Obstructive sleep apnea in hypothyroidism publication-title: Ann Intern Med doi: 10.7326/0003-4819-101-4-491 – volume: 130 year: 2006 article-title: Upper airway obstruction in a patient with severe hypothyroidism presenting as postextubation stridor publication-title: Chest doi: 10.1378/chest.130.4_MeetingAbstracts.315S-a – volume: 87 start-page: 123 year: 1973 article-title: Mild hypothyroidism and its effects on the larynx publication-title: J Laryngol Otol doi: 10.1017/S0022215100076696 – volume: 98 start-page: 2936 year: 2013 article-title: The relationship between TSH and free T₄ in a large population is complex and nonlinear and differs by age and sex publication-title: J Clin Endocrinol Metab doi: 10.1210/jc.2012-4223 – volume: 24 start-page: 1670 year: 2014 article-title: Guidelines for the treatment of hypothyroidism: prepared by the American thyroid association Task force on thyroid hormone replacement publication-title: Thyroid doi: 10.1089/thy.2014.0028 – volume: 96 start-page: 385 year: 2012 article-title: Thyroid emergencies publication-title: Med Clin North Am doi: 10.1016/j.mcna.2012.01.015 – volume: 22 start-page: 1200 year: 2012 article-title: Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American association of clinical endocrinologists and the American thyroid association publication-title: Thyroid doi: 10.1089/thy.2012.0205 – volume: 44 year: 2016 article-title: Hospital variation in early tracheostomy in the United States: a population-based study publication-title: Crit Care Med doi: 10.1097/CCM.0000000000001674 – volume: 134 start-page: 348 year: 2006 article-title: Supraglottic myxedema presenting as acute upper airway obstruction publication-title: Otolaryngol Head Neck Surg doi: 10.1016/j.otohns.2005.03.069 – volume: 113 start-page: 1931 year: 2003 article-title: Identification of thyroid hormone receptors in the human larynx publication-title: Laryngoscope doi: 10.1097/00005537-200311000-00014 – volume: 39 start-page: 42 year: 1960 article-title: The pulmonary abnormalities in myxedema publication-title: J Clin Invest doi: 10.1172/JCI104025 – volume: 58 start-page: 169 year: 1982 article-title: Myxoedema presenting with severe laryngeal obstruction publication-title: Postgrad Med J doi: 10.1136/pgmj.58.677.169 – volume: 77 start-page: 245 year: 1992 article-title: Evaluation of risk factors for laryngeal edema after tracheal extubation in adults and its prevention by dexamethasone. 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| SubjectTerms | Biopsy Case Report Case reports Diabetes Ears & hearing Edema Female Hormone replacement therapy Humans Hypothyroidism Hypothyroidism - complications Hypothyroidism - drug therapy Intubation Larynx Larynx - diagnostic imaging Literature reviews Middle Aged Myxedema - complications Myxedema - diagnosis Myxedema - drug therapy Ostomy Pituitary gland Pulmonary embolisms Sleep apnea Thyroid gland Thyroxine - therapeutic use Tracheostomy Tracheotomy |
| Title | Laryngeal myxoedema: a literature review of an uncommon complication of hypothyroidism |
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