Ques. 1 What is Myxoedema?
Ans. It is a diseased condition occurring in adults, marked by a thickening of sub-cutaneous tissue. It may occur endemically or sporadically.
Causes: Sex-commonly female, Age-mostly middle age.
- Prolonged iodine therapy.
- Idiopathic thyroid fibrosis.
- Hashimoto’s disease.
- Simmond’s disease.
Ques. 2 What is the Pathology of Myxoedema?
Ans. The thyroid is small and hard with replacement of fibrosis. There is a protein infiltration of skin and sub-cutaneous tissue :- mucous membranes of the nasopharynx, mouth and ear also in larynx and oesophagus. Coronary blood vessels are sometimes atheromatous and heart is dilated. Testes/ovaries atrophy.
Ques. 3 What are the symptoms and signs of Myxoedema?
Ans. Symptoms –
- Dryness and roughness of skin.
- Pain in muscles and joints, clumsy gait, rheumatism.
- Constipation or obstipation.
- Dyspnoea, orthopnoea, dizziness.
- Menometrorrhagia, may be amenorrhoea or sterility or habitual abortion.
- Polyuria with nocturia.
- Slowness of thought, loss of memory, drowsiness, hallucination.
- Sometimes obese inspite of diminished appetite.
- Headache, deafness, decreased visual acuity, ataxia, convulsion, facial neuralgia and coma.
- Weakness and lethargy.
- Low temperature, always require covering, prefer warm weather and room.
- Pallor of skin.
- Vertigo, tinnitus impaired hearing, chronic hoarseness or sinusitis.
- Skin thick, rough, dry and scaly on extremities.
- Moderate obesity, non-pitting oedema.
- Teeth may decay rapidly.
- Thyroid usually small and hard to palpate.
- Heat sounds slow (40 to 60 p.m.), distant, muffled.
- Hypotension in early stage ; hypertension may develop later.
- Diminished deep tendon reflexes.
- Puffy features, ‘apple-blossom’ cheeks.
- Slow speech with leathery, deep, hollow tones.
- Hair dry, sometimes baldness.
- Body temperature low (95°F).
Ques. 4 How can we Diagnose Myxoedema?
- Butonol extractable iodine-low.
- Serum cholesterol level-high.
- Urinary 17-ketosteroids-usually low.
- Glucose tolerance test-curve tends to be low & flat.
- B.M.R. – low.
- Serum protein-bound jodine-low.
- Radioactive iodine uptake-low.
- Coronary infarction and insufficiency.
- Pituitary myxoedema.
- Chronic nephritis.
- Thyroxine-Initial dose 0.25 mg. daily gradually increased to minimum maintenance dose.
- Laevo-thyroxine sodium (Eltroxin) – Initial does 0.05 mg. daily, gradually increased to minimum maintenance dose.
- Ventilatory assistance and steroid may be given.
- Treatment is to be continued all throughout life.
- Symptomatic treatment.
- Homoeopathic remedies.
THYROIDINUM – Weakness. Easy fatigue, tendency to fainting, palpitation, cold bands and feet, low blood pressure, chilliness and sensitive to cold, weak pulse.