Amiodarone-induced myxoedema coma as a rare differential diagnosis of consciousness disturbance

Abstract

Myxoedema coma is an uncommon and life-threatening endocrine emergency with a high mortality rate. This entity is the extreme expression of severe hypothyroidism and the cardinal features are decreased mental status and hypothermia. Diagnosis is challenging and a high index of suspicion is crucial because it allows an early recognition of this condition and prompt initiation of supportive measures along with adequate thyroid replacement therapy. Herein, we report an extremely rare case of myxoedema coma secondary to amiodarone in a 90-year-old female with no previous history of thyroid disease, which was successfully treated with thyroid hormone replacement. Although its rarity, we emphasize that myxoedema coma should be included in the differential diagnosis of consciousness disturbances, particularly in patients under amiodarone therapy.