A patient is seen in the emergency department after abruptly discontinuing her thyroid medication. She is hypotensive, hypoglycemic, and is unresponsive. This clinical picture is most consistent with


• Myxedema coma occurs from persistently low thyroid production. It occurs after acute illnesses, rapid discontinuation of thyroid medication, or hypothermia.

• Signs and symptoms include hypotension, coma, hypoglycemia, edema, bradycardia, and respiratory failure.

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