Myxoedema coma

Liothyronine Tabs. Liothyronine is the most rapidly effective thyroid hormone, a single dose giving maximum effect within 24 h and passing off over 24—48 h. It is not used in routine treatment of hypothyroidism because its rapid onset of effect can induce heart failure. Its main uses are in myxoedema coma and psychosis, both rare conditions. A specialised use is during the withdrawal of levothyroxine replacement (to permit diagnostic radioiodine scanning) in patients with thyroid carcinoma. 

Myxoedema coma follows prolonged total hormone deficiency and constitutes an emergency. Intravenous therapy is mandatory because of impaired absorption of drugs in this condition. Liothyronine 5-20 micrograms is given every 12 hours. Hydrocortisone i.v. is also needed, as prolonged hypothyroidism may be associated with adrenocortical insufficiency. 

Khaleeli AA. Quinaband-induced thrombocytopenic purpura in a patient with myxoedema coma. BMJ 1976 2(6035) 562-3. 

The condition that results from inadequate secretion of thyroid hormones. The clinical features include weight gain, dry skin, loss of hair, a hoarse voice and thickening of the subcutaneous tissues (myxoedema). If the disease goes undetected, a myx-oedema coma may develop. 

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