An autopsy case report of a patient with myxedema coma

Abstract Background Myxedema coma, a life-threatening complication of severe hypothyroidism, is associated with high mortality. Detailed autopsy findings from multiple organs in myxedema coma are rarely reported. Case presentation We present the autopsy findings of an 82-year-old man with hypothyroi...

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Main Authors: Syuichi Tetsuka, Chisa Ashida, Shoichiro Ueno, Ryuta Nakamura, Mio Nihei, Tomoko Ogawa, Yoshimasa Nakazato
Format: Article
Language:English
Published: SpringerOpen 2025-03-01
Series:Egyptian Journal of Forensic Sciences
Subjects:
Online Access:https://doi.org/10.1186/s41935-025-00433-5
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author Syuichi Tetsuka
Chisa Ashida
Shoichiro Ueno
Ryuta Nakamura
Mio Nihei
Tomoko Ogawa
Yoshimasa Nakazato
author_facet Syuichi Tetsuka
Chisa Ashida
Shoichiro Ueno
Ryuta Nakamura
Mio Nihei
Tomoko Ogawa
Yoshimasa Nakazato
author_sort Syuichi Tetsuka
collection DOAJ
description Abstract Background Myxedema coma, a life-threatening complication of severe hypothyroidism, is associated with high mortality. Detailed autopsy findings from multiple organs in myxedema coma are rarely reported. Case presentation We present the autopsy findings of an 82-year-old man with hypothyroidism who developed myxedema coma despite levothyroxine treatment. The patient had been under the added stress of trauma and cold exposure before developing a myxedema coma. He exhibited severe hypothermia, hypotension, and reduced thyroid hormone levels. Despite intensive treatment, he died six days after admission. Autopsy revealed pericardial and pleural effusions, and histological evidence of edematous adipose tissue infiltration containing mucopolysaccharides in multiple organs, including the heart, thyroid, pancreas, and kidneys. Conclusions This case highlights that both trauma and cold exposure can serve as critical triggers for myxedema coma, underscoring the importance of proactive management in hypothyroid patients at risk. These risk factors should be carefully considered in clinical practice to prevent severe complications. Our autopsy findings provide the first evidence that myxedema can manifest not only in subcutaneous tissue but also in internal organs, expanding the understanding of its pathophysiology. These insights may contribute to improved prevention and management of myxedema coma, offering a deeper understanding of this life-threatening condition.
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issn 2090-5939
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publishDate 2025-03-01
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series Egyptian Journal of Forensic Sciences
spelling doaj-art-b8f5cc990fbe44349910169c2f1f369d2025-08-20T03:41:40ZengSpringerOpenEgyptian Journal of Forensic Sciences2090-59392025-03-011511710.1186/s41935-025-00433-5An autopsy case report of a patient with myxedema comaSyuichi Tetsuka0Chisa Ashida1Shoichiro Ueno2Ryuta Nakamura3Mio Nihei4Tomoko Ogawa5Yoshimasa Nakazato6International University of Health and Welfare HospitalInternational University of Health and Welfare HospitalInternational University of Health and Welfare HospitalInternational University of Health and Welfare HospitalInternational University of Health and Welfare HospitalInternational University of Health and Welfare HospitalInternational University of Health and Welfare HospitalAbstract Background Myxedema coma, a life-threatening complication of severe hypothyroidism, is associated with high mortality. Detailed autopsy findings from multiple organs in myxedema coma are rarely reported. Case presentation We present the autopsy findings of an 82-year-old man with hypothyroidism who developed myxedema coma despite levothyroxine treatment. The patient had been under the added stress of trauma and cold exposure before developing a myxedema coma. He exhibited severe hypothermia, hypotension, and reduced thyroid hormone levels. Despite intensive treatment, he died six days after admission. Autopsy revealed pericardial and pleural effusions, and histological evidence of edematous adipose tissue infiltration containing mucopolysaccharides in multiple organs, including the heart, thyroid, pancreas, and kidneys. Conclusions This case highlights that both trauma and cold exposure can serve as critical triggers for myxedema coma, underscoring the importance of proactive management in hypothyroid patients at risk. These risk factors should be carefully considered in clinical practice to prevent severe complications. Our autopsy findings provide the first evidence that myxedema can manifest not only in subcutaneous tissue but also in internal organs, expanding the understanding of its pathophysiology. These insights may contribute to improved prevention and management of myxedema coma, offering a deeper understanding of this life-threatening condition.https://doi.org/10.1186/s41935-025-00433-5HypothyroidismMyxedema comaAutopsyVisceral adiposeMucopolysaccharidesGelatinous degeneration
spellingShingle Syuichi Tetsuka
Chisa Ashida
Shoichiro Ueno
Ryuta Nakamura
Mio Nihei
Tomoko Ogawa
Yoshimasa Nakazato
An autopsy case report of a patient with myxedema coma
Egyptian Journal of Forensic Sciences
Hypothyroidism
Myxedema coma
Autopsy
Visceral adipose
Mucopolysaccharides
Gelatinous degeneration
title An autopsy case report of a patient with myxedema coma
title_full An autopsy case report of a patient with myxedema coma
title_fullStr An autopsy case report of a patient with myxedema coma
title_full_unstemmed An autopsy case report of a patient with myxedema coma
title_short An autopsy case report of a patient with myxedema coma
title_sort autopsy case report of a patient with myxedema coma
topic Hypothyroidism
Myxedema coma
Autopsy
Visceral adipose
Mucopolysaccharides
Gelatinous degeneration
url https://doi.org/10.1186/s41935-025-00433-5
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