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MYXOEDEMA
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=>GENERAL INFO:
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Hypothyroidism is a condition in which the body lacks sufficient thyroid hormone called thyroxine. Since the main purpose of thyroid hormone is to maintain the body's metabolism, people with this condition will have symptoms associated with a slow metabolism.
=>ROLE OF THYROID GLAND:
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AS ALSO DISCUSSED IN HYPERTHYROIDISM.
Thyroid hormones are produced by the thyroid gland. This gland is located in the lower part of the neck, below the Adam’s apple. The gland wraps around the windpipe (trachea) and has a shape that is similar to a butterfly formed by two wings (lobes) and attached by a middle part (isthmus). These hormones also have direct effects on most organs, including the heart. As the disease becomes more severe, there may be puffiness around the eyes, a slowing of the heart rate, a drop in body temperature, and heart failure medically known as myxoedema. In its most profound form, severe hypothyroidism may lead to a life-threatening coma (myxoedema coma).The condition is more common in women than in men, and its incidence increases with age.
=>CAUSES:
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Inflammation of the thyroid gland which leaves a large percentage of the cells of the thyroid.
(1)=> Hashimoto's Thyroiditis:
The most common cause of hypothyroidism is an inherited condition called Hashimoto's thyroiditis. This condition is named after Dr. Hakaru Hashimoto who first described it in 1912. In this condition, the thyroid gland is usually enlarged (goiter) and has a decreased ability to make thyroid hormones. Hashimoto’s is an autoimmune disease in which the body’s immune system inappropriately attacks the thyroid tissue.
If the total mass of thyroid producing cells left within the body are not enough to meet the needs of the body, the patient will develop hypothyroidism. This can develop after partial surgical removal of the thyroid gland.
(2)=> Lymphocytic Thyroiditis :
Thyroiditis refers to inflammation of the thyroid gland. When the inflammation is caused by a particular type of white blood cell known as a lymphocyte, the condition is referred to as lymphocytic thyroiditis. This condition is particularly common after pregnancy.
(3)=>Thyroid Destruction:
(from radioactive iodine or surgery).
(4)=> Pituitary or Hypothalamic Disease
(5)=> Medications:
Medications that are used to treat an over-active thyroid (hyperthyroidism) may actually cause hypothyroidism. The psychiatric medication, lithium, is also known to alter thyroid function and cause hypothyroidism.
(6)=> Severe Iodine Deficiency:
In areas of the world where there is an iodine deficiency in the diet, severe hypothyroidism can be seen in 5 to 15% of the population. Examples of these areas include Zaire, Ecuador, India,& hilly areas in pakistan like Murree,sawat ect. Severe iodine deficiency is also seen in remote mountain areas such as the Andes and the Himalayas. Since the addition of iodine to table salt and to bread, iodine deficiency is rarely seen in the United States.
=>SYMPTOMS:
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-> Lethargy.
-> Constipation.
-> Cold intolerance.
-> Stiffing and cramping of muscles.
-> Carpal tunnel syndrome & menorrhagia.
-> Decreased appetite.
-> Increase in weight.
-> Dry skin, Dry hair.
-> Dull expressionless face.
-> Sparse hair.
-> Periorbital puffiness.
-> Large tongue.
-> Pale, doughy and cool skin.
=>DIAGNOSIS:
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A diagnosis of hypothyroidism can be suspected in patients with fatigue, cold intolerance, constipation, and dry, flaky skin. A blood test is needed to confirm the diagnosis. When hypothyroidism is present, the blood levels of thyroid hormones can be measured directly and are usually decreased. However, in early hypothyroidism, the level of thyroid hormones (T3 and T4) may be normal. If a pituitary or hypothalmic cause is suspected, an MRI of the brain and other studies may be warranted. T waves may be present on electrocardiogram (ECG).
=>TREATMENT:
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Increasing the level of thyroid hormone is the basic aim of the treatment and for this, "LEVOTHYROXINE" is preferred treatment. In secondary hypothyroidism, other hormonal glands disorder like adrenal insufficiency is to be evaluated and treated.
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