Myxedema

Q: Edema in myxedema is usually? (select one)

A) pitting 

B) non-pitting 

Answer: B

The objective of this question is to underline the importance of bedside clinical exam. The two hallmarks clinical signs of myxedema  are

• mental status change, and
• hypothermia (may mask signs of infection)

Other common signs are hypotension, low respiratory and heart rate, hyponatremia, hypoglycemia, puffiness of the hands and face, a thickened nose, swollen lips, and an enlarged tongue. The nonpitting edema is due to deposits of albumin and mucin in the skin and other tissues, known as myxedema.

#endocrine

References:

1. Ono Y, Ono S, Yasunaga H, et al. Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan. J Epidemiol 2017; 27:117. 

2. Wiersinga WM. Myxedema and Coma (Severe Hypothyroidism) [Updated 2018 Apr 25]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279007/