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...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2015-05-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/5868/13008_CE[Ra]_F(P)_PF1(NJAK)_PFA(P)_PF2(PAG).pdf |
| _version_ | 1818143650258878464 |
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| author | Siddharth Dixit Manoj Kumar Dutta Mayank Namdeo |
| author_facet | Siddharth Dixit Manoj Kumar Dutta Mayank Namdeo |
| author_sort | Siddharth Dixit |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-11T11:35:02Z |
| format | Article |
| id | doaj.art-53aa236c71814894a68680bc3a3f5889 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-11T11:35:02Z |
| publishDate | 2015-05-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-53aa236c71814894a68680bc3a3f58892022-12-22T01:08:47ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2015-05-0195VD01VD0310.7860/JCDR/2015/13008.5868A Rare Case of Myxedema Coma with Neuroleptic Malignant Syndrome (NMS)Siddharth Dixit0Manoj Kumar Dutta1Mayank Namdeo2Classified Specialist Psychiatry, Department of Psychiatry, Base Hospital, Delhi Cantt, Assistant Professor, Department of Psychiatry, Army College of Medical Science, New Delhi, India.Classified Specialist Endocrinology Base Hospital Delhi Cantt. Assistant Professor, Army College of Medical Science, New Delhi, India.DNB Resident, Department of Psychiatry, Base Hospital, Delhi Cantt, India.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.https://jcdr.net/articles/PDF/5868/13008_CE[Ra]_F(P)_PF1(NJAK)_PFA(P)_PF2(PAG).pdfatypical antipsychoticsatypical neuroleptic malignant syndromehypothyroid crisisprimary hypothyroidism |
| spellingShingle | Siddharth Dixit Manoj Kumar Dutta Mayank Namdeo A Rare Case of Myxedema Coma with Neuroleptic Malignant Syndrome (NMS) Journal of Clinical and Diagnostic Research atypical antipsychotics atypical neuroleptic malignant syndrome hypothyroid crisis primary hypothyroidism |
| title | A Rare Case of Myxedema Coma with Neuroleptic Malignant Syndrome (NMS) |
| title_full | A Rare Case of Myxedema Coma with Neuroleptic Malignant Syndrome (NMS) |
| title_fullStr | A Rare Case of Myxedema Coma with Neuroleptic Malignant Syndrome (NMS) |
| title_full_unstemmed | A Rare Case of Myxedema Coma with Neuroleptic Malignant Syndrome (NMS) |
| title_short | A Rare Case of Myxedema Coma with Neuroleptic Malignant Syndrome (NMS) |
| title_sort | rare case of myxedema coma with neuroleptic malignant syndrome nms |
| topic | atypical antipsychotics atypical neuroleptic malignant syndrome hypothyroid crisis primary hypothyroidism |
| url | https://jcdr.net/articles/PDF/5868/13008_CE[Ra]_F(P)_PF1(NJAK)_PFA(P)_PF2(PAG).pdf |
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