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URL
https://doi.org/10.7759/cureus.21155
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Title
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Status Epilepticus as a Life-Threatening Manifestation of Myxedema Crisis
Creator
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Francisco J Somoza-Cano
Abdul Rahman Al Armashi
Kanchi Patell
Faris Hammad
Keyvan Ravakhah
Date
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2022
Description
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Myxedema coma is a rare life-threatening emergency that usually presents in the elderly during the winter months. The neurological changes caused by uncontrolled hypothyroidism may precipitate seizure activity and its deleterious consequences. A 65-year-old homeless man with a history of non-Hodgkin lymphoma in remission for over 20 years presented to the emergency department (ED) following an episode of syncope. His physical examination was remarkable for hypothermia and bradycardia. Shortly after the admission, he had two tonic-clonic seizures with sphincter relaxation and no recovery between the convulsions. His thyroid-stimulating hormone (TSH) level was 304 uIU/ml. He received appropriate treatment for his condition and was discharged after a full recovery. This case illustrates the catastrophic consequences of long-term uncontrolled hypothyroidism. A high index of clinical suspicion is essential for beginning prompt hormone supplementation in such patients.
Source
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Cureus
. 2022 Jan 12;14(1):e21155. doi: 10.7759/cureus.21155. eCollection 2022 Jan.
Language
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English
2022
bradycardia
Cellulitis
HOMELESSNESS
hypothermia
hypothyroidism
myxedema coma
status epilepticus.
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Text
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URL Address
<a href="http://doi.org/10.1002/jor.22467" target="_blank" rel="noreferrer noopener">http://doi.org/10.1002/jor.22467</a>
Rights
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Pages
1986-1991
Issue
12
Volume
31
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Title
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The Effects of Hypothyroidism on the Proximal Femoral Physis in Miniature Swine
Publisher
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Journal of Orthopaedic Research
Date
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2013
2013-12
Subject
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cartilage; catch-up growth; chondrocyte differentiation; disease; endochondral bone-formation; epiphysis; growth-plate; growth-plate senescence; head; hypothyroidism; ischemic necrosis; miniature swine; Orthopedics; perthes; slipped capital femoral; thyroid-hormone
Creator
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Tank J C; Weiner D S; Jacquet R; Childs D; Ritzman T F; Horne W I; Steiner R; Morscher M A; Landis W J
Description
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As a potential means of comparing hypothyroidism in humans, this work intended to establish a defined hypothyroid state in immature miniature swine and evaluate specific molecular, cellular, and extracellular responses of their growth plates. Two male, 11-week-old Sinclair miniature swine were given 6-propyl-2-thiouracil (PTU) in their water and two other like animals (controls) were provided water without PTU. Blood levels of thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxin (T4) were monitored weekly. At 25 weeks of age, the hind limb proximal femoral physes were harvested and divided into portions for histology and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) analysis. Compared to controls, swine administered PTU exhibited increased TSH and decreased T3 and T4 serum levels during the study period, features consistent with a hypothyroid state. Compared to controls, hypothyroid swine exhibited structurally altered physes and demonstrated significantly decreased gene expression of aggrecan (p<0.05) and type X collagen (p0.1). This is the first hypothyroid model established in miniature swine and represents a potentially important advance for understanding the condition in humans, in which, like this swine model, there are changes critical to growth plate molecular biology, biochemistry and structure. (c) 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31:1986-1991, 2013
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<a href="http://doi.org/10.1002/jor.22467" target="_blank" rel="noreferrer noopener">10.1002/jor.22467</a>
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Journal Article
2013
Cartilage
catch-up growth
Childs D
chondrocyte differentiation
Disease
endochondral bone-formation
Epiphysis
growth-plate
growth-plate senescence
head
Horne W I
hypothyroidism
ischemic necrosis
Jacquet R
Journal Article
Journal of Orthopaedic Research
Landis W J
miniature swine
Morscher M A
Orthopedics
perthes
Ritzman T F
slipped capital femoral
Steiner R
Tank J C
thyroid-hormone
Weiner D S