Alan Farwell

All articles by Alan Farwell

Are you sure the patient has myxedema coma? Clinical Features of Myxedema Coma Myxedema coma is a rare syndrome that represents the extreme expression of severe, longstanding hypothyroidism. It is a medical emergency and, even with early diagnosis and treatment, the mortality can be as high as 60%. The name is somewhat a misnomer, as…

Are you sure the patient has thyroid storm? Thyroid storm (also known as hyperthyroid crisis, thyroid crisis, or thyrotoxic crisis) is a rare, life-threatening complication of thyrotoxicosis, which is usually precipitated by an intercurrent medical problem. The incidence of thyroid storm was once relatively high because of a liberal definition of the condition. For example,…

Are you sure the patient has nonthyroidal illness? Critical illness causes multiple nonspecific alterations in thyroid hormone concentrations that relate to the severity of the illness in patients who have no intrinsic thyroid disease. There is an ongoing debate whether such alterations are a physiologic adaptation or a pathologic perturbation. Due to the complexity of…