Abstract
Myxoedema coma is a rare and extreme presentation of hypothyroidism. It has a poor prognosis due to multisystem decompensation, and demands prompt but careful management in a high-dependency / intensive care setting. Early recognition of hypercapnia, hyponatraemia, and sepsis are especially important. Treatment should begin on suspicion of the diagnosis and can be life-saving. Intravenous thyroid hormone replacement is required at first, with steroid cover, although the optimum dose regimen remains unclear.
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