A Rare Case of Myxedema Coma with Neuroleptic Malignant Syndrome (NMS)
Myxedema coma or hypothyroid crisis is an endocrine emergency and needs ICU management. Neuroleptic malignant syndrome (NMS) is another medical emergency which needs high degree of clinical suspicion else mortality can be high. There is a paradox in co existence of myxedema coma and NMS. While one...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2015-05-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/5868/13008_CE[Ra]_F(P)_PF1(NJAK)_PFA(P)_PF2(PAG).pdf |
| Summary: | Myxedema coma or hypothyroid crisis is an endocrine emergency and needs ICU management. Neuroleptic malignant syndrome
(NMS) is another medical emergency which needs high degree of clinical suspicion else mortality can be high. There is a paradox in co
existence of myxedema coma and NMS. While one is hypometabolic state another is hypermetabolic state and both can be precipitated
by antipsychotics use. Hypothermia and flaccidity commonly expected in myxedema coma may mask fever and rigidity of classical NMS
contributing to diagnostic problem and treatment delay. Scientific literature on coexistance of myxedema coma and NMS is sparse.
We hereby report first case with coexisting myxedema coma and NMS in a patient of schizophrenia treated with antipsychotic, where
classical symptoms of NMS were masked by myxedema coma. Prompt diagnosis and effective management by a team resulted in
favourable outcome in our patient. This case is reported to alert intensive care physicians to atypical manifestations of NMS in presence
of hypothyroidism. |
|---|---|
| ISSN: | 2249-782X 0973-709X |