<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1561-2953</journal-id>
<journal-title><![CDATA[Revista Cubana de Endocrinología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Endocrinol]]></abbrev-journal-title>
<issn>1561-2953</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1561-29532022000100008</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Elementos básicos para el diagnóstico y manejo terapéutico del coma mixedematoso en el paciente adulto]]></article-title>
<article-title xml:lang="en"><![CDATA[Basic elements for the diagnosis and therapeutic management of myxedematous coma in adult patients]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández Rodríguez]]></surname>
<given-names><![CDATA[José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Ciencias Médicas de La Habana Instituto de Endocrinología (INEN) ]]></institution>
<addr-line><![CDATA[ La Habana]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2022</year>
</pub-date>
<volume>33</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1561-29532022000100008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1561-29532022000100008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1561-29532022000100008&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  A pesar de su baja incidencia, la gravedad del cuadro clínico y la alta mortalidad hacen del coma mixedematoso una complicación a tener en cuenta.  Objetivo:  Describir los elementos básicos para el diagnóstico y manejo terapéutico del coma mixedematoso en el paciente adulto.  Métodos:  Se realizó una búsqueda de literatura relevante sobre el tema. Se utilizaron buscadores de información científica como Pubmed y Google Académico. La estrategia de búsqueda incluyó los siguientes términos como palabras clave: hipotiroidismo primario, hipotiroidismo subclínico, diagnóstico y tratamiento. Fueron evaluados artículos de revisión, de investigación y páginas web que tuvieran menos de 10 años de publicados. Se consideraron los textos en idioma español e inglés y que hicieran referencia específicamente al tema de estudio a través del título. Fueron excluidos los artículos que no cumplieron con estas condiciones. Esto permitió el estudio de 64 artículos, de los cuales 40 fueron referenciados.  Conclusiones:  Para el diagnóstico del coma mixedematoso en el paciente adulto lo más importante es sospecharlo en aquellas personas que presenten factores precipitantes, acompañados de síntomas y signos de hipotiroidismo severo con diferentes grados de insuficiencia del sistema nervioso central, hipotermia, hipoventilación, insuficiencia circulatoria e hiponatremia. A esto se sumaría el escenario humoral característico y los posibles hallazgos dependientes de la enfermedad causante del hipotiroidismo. Se debe tratar con un reemplazo agresivo de levotiroxina sódica (vía endovenosa u oral, según posibilidades), unido a otras medidas de apoyo en el entorno hospitalario.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Despite its low incidence, the severity of the clinical picture and the high mortality make myxedematous coma a complication to be taken into account.  Objective:  Describe the basic elements for the diagnosis and therapeutic management of myxedematous coma in adult patients.  Methods:  A search of relevant literature on the subject was carried out. Pubmed and Google Scholar were used as search engines for scientific information. The search strategy included the following keyword terms: primary hypothyroidism, subclinical hypothyroidism, diagnosis and treatment. Review articles, research articles and Web pages that, in general, had less than 10 years of publication, in Spanish and English that specifically referred to the subject of study through the title were evaluated. Articles that did not meet these conditions were excluded. This allowed the study of 64 articles, of which 40 were referenced.  Conclusions:  For the diagnosis of myxedematous coma in the adult patient, the most important thing is to suspect it in those people who present precipitating factors, accompanied by symptoms and signs of severe hypothyroidism with different degrees of central nervous system insufficiency, hypothermia, hypoventilation, circulatory insufficiency and hyponatremia. To this would be added the characteristic humoral scenario and the possible findings dependent on the disease causing hypothyroidism. It should be treated with an aggressive replacement of levothyroxine sodium (intravenous or oral way, accodring to the possibilities), together with other supportive measures in the hospital setting.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[hipotiroidismo]]></kwd>
<kwd lng="es"><![CDATA[coma mixedematoso]]></kwd>
<kwd lng="es"><![CDATA[diagnóstico y tratamiento]]></kwd>
<kwd lng="en"><![CDATA[hypothyroidism]]></kwd>
<kwd lng="en"><![CDATA[myxedematous coma]]></kwd>
<kwd lng="en"><![CDATA[diagnosis and treatment]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hershman]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
</person-group>
<source><![CDATA[Hipotiroidismo. Manual Msd]]></source>
<year>2019</year>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rizzo]]></surname>
<given-names><![CDATA[LF]]></given-names>
</name>
<name>
<surname><![CDATA[Mana]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
<name>
<surname><![CDATA[Bruno]]></surname>
<given-names><![CDATA[OD]]></given-names>
</name>
<name>
<surname><![CDATA[Wartofsky]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coma mixedematoso]]></article-title>
<source><![CDATA[Medicina]]></source>
<year>2017</year>
<volume>77</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>321-8</page-range><publisher-loc><![CDATA[Buenos Aires ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Uzun]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Management of myxedema coma]]></article-title>
<source><![CDATA[Evidence-Based Critical Care]]></source>
<year>2017</year>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chaker]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Bianco]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Jonklaas]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Peeters]]></surname>
<given-names><![CDATA[RP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypothyroidism]]></article-title>
<source><![CDATA[Lancet]]></source>
<year>2017</year>
<volume>390</volume>
<numero>10101</numero>
<issue>10101</issue>
<page-range>1550-62</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Leal]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coma mixedematoso]]></article-title>
<source><![CDATA[Rev Cub Endocrinol]]></source>
<year>2012</year>
<volume>23</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>273-80</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[OR]]></given-names>
</name>
<name>
<surname><![CDATA[Álvarez]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[López]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Flores]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Ortega]]></surname>
<given-names><![CDATA[HR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coma mixedematoso]]></article-title>
<source><![CDATA[Med Int Mex]]></source>
<year>2020</year>
<volume>36</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>859-67</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ono]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Ono]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Yasunaga]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Matsui]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Fushimi]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Tanaka]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan]]></article-title>
<source><![CDATA[J Epidemiol]]></source>
<year>2017</year>
<volume>27</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>117-22</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wiersinga]]></surname>
<given-names><![CDATA[WM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypothyroidism and myxedema coma]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[DeGroot]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
<name>
<surname><![CDATA[Jameson]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
</person-group>
<source><![CDATA[Endocrinology adult and pediatric]]></source>
<year>2016</year>
<edition>7th</edition>
<page-range>1540-56</page-range><publisher-loc><![CDATA[Philadelphia ]]></publisher-loc>
<publisher-name><![CDATA[Elsevier-Saunders]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Trimboli]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Camponovo]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Scappaticcio]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Bellastella]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Piccardo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Rotondi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thyroid sequelae of COVID-19: a systematic review of reviews]]></article-title>
<source><![CDATA[Reviews in Endocrine and Metabolic Disorders]]></source>
<year>2021</year>
<volume>22</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>485-91</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Tian]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Zhu]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Wei]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Lei]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Potential interaction between SARS-CoV-2 and thyroid: A review]]></article-title>
<source><![CDATA[Endocrinology]]></source>
<year>2021</year>
<volume>162</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Speer]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Somogyi]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thyroid complications of SARS and coronavirus disease 2019 (COVID-19)]]></article-title>
<source><![CDATA[Endocr J]]></source>
<year>2021</year>
<volume>68</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>129-36</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dixit]]></surname>
<given-names><![CDATA[NM]]></given-names>
</name>
<name>
<surname><![CDATA[Truong]]></surname>
<given-names><![CDATA[KP]]></given-names>
</name>
<name>
<surname><![CDATA[Rabadia]]></surname>
<given-names><![CDATA[SV]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Srivastava]]></surname>
<given-names><![CDATA[PK]]></given-names>
</name>
<name>
<surname><![CDATA[Mosaferi]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sudden cardiac arrest in a patient with myxedma coma and COVID-19]]></article-title>
<source><![CDATA[J Endocrine Society]]></source>
<year>2020</year>
<volume>4</volume>
<numero>10</numero>
<issue>10</issue>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Montjoy]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnóstico clínico y de laboratorio del hipotiroidismo. Manual de Diagnóstico y Tratamiento del Hipotiroidismo]]></article-title>
<source><![CDATA[Merck Serono Perú]]></source>
<year>2014</year>
<page-range>57-63</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pineda]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Galofré]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Toni]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Anda]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hipotiroidismo]]></article-title>
<source><![CDATA[Med]]></source>
<year>2016</year>
<volume>12</volume>
<numero>13</numero>
<issue>13</issue>
<page-range>722-30</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[López]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Hidalgo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Bellido]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Pérula]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hipotiroidismo adulto en una zona básica de salud]]></article-title>
<source><![CDATA[Medicina de familia. SEMERGEN]]></source>
<year>2018</year>
<volume>44</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>174-9</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Islam]]></surname>
<given-names><![CDATA[MI]]></given-names>
</name>
<name>
<surname><![CDATA[Ali]]></surname>
<given-names><![CDATA[MZ]]></given-names>
</name>
<name>
<surname><![CDATA[Islam]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Solayman]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hoque]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypothyroidism a new view on an old disease]]></article-title>
<source><![CDATA[KYAMC J]]></source>
<year>2016</year>
<volume>7</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>707-13</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[RI]]></given-names>
</name>
<name>
<surname><![CDATA[Jiménez]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Conde]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Arzate]]></surname>
<given-names><![CDATA[RE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tiroiditis de Hashimoto en una adolescente con obesidad]]></article-title>
<source><![CDATA[Rev Cient Cienc Med]]></source>
<year>2019</year>
<volume>22</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>62-7</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Junchaya]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Síndrome de hipotiroidismo]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Rocca]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Manual de Diagnóstico y Tratamiento del Hipotiroidismo]]></source>
<year>2014</year>
<volume>136</volume>
<page-range>31-7</page-range><publisher-loc><![CDATA[Perú ]]></publisher-loc>
<publisher-name><![CDATA[Merck Serono]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Popoveniuc]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Chandra]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Sud]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Sharma]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Blackman]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Burman]]></surname>
<given-names><![CDATA[KD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A diagnostic scoring system for myxedema coma]]></article-title>
<source><![CDATA[Endocrine Practice]]></source>
<year>2014</year>
<volume>20</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>808-17</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chiong]]></surname>
<given-names><![CDATA[YV]]></given-names>
</name>
<name>
<surname><![CDATA[Bammerlin]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Mariash]]></surname>
<given-names><![CDATA[CN]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Development of an objective tool for the diagnosis of myxedema coma]]></article-title>
<source><![CDATA[Translational Research]]></source>
<year>2015</year>
<volume>166</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>233-43</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Albín]]></surname>
<given-names><![CDATA[RG]]></given-names>
</name>
<name>
<surname><![CDATA[Parada]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ramírez]]></surname>
<given-names><![CDATA[JO]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coma mixedematoso como presentación de hipotiroidismo]]></article-title>
<source><![CDATA[Acta Med Costarric]]></source>
<year>2019</year>
<volume>61</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>187-9</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ramírez]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Huari]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Ayala]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coma mixedematoso: Case report]]></article-title>
<source><![CDATA[Rev Fac Med Hum]]></source>
<year>2019</year>
<volume>19</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>86-94</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Neves]]></surname>
<given-names><![CDATA[RK]]></given-names>
</name>
<name>
<surname><![CDATA[Oliveira]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Delmondes]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[De Souza]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coma mixedematoso em paciente com síndrome do eutireoideo doente: um relato de caso]]></article-title>
<source><![CDATA[Brazilian J Health Review]]></source>
<year>2021</year>
<volume>4</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>9868-77</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Haghi]]></surname>
<given-names><![CDATA[AR]]></given-names>
</name>
<name>
<surname><![CDATA[Solhjoo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Tavakoli]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Correlation between subclinical hypothyroidism and dyslipidemia]]></article-title>
<source><![CDATA[Iran J Pathol]]></source>
<year>2017</year>
<volume>12</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>106-11</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McDermott]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypothyroidism]]></article-title>
<source><![CDATA[Annals Internal Med]]></source>
<year>2020</year>
<volume>173</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>ITC1-16</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jonklaas]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bianco]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Bauer]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Burman]]></surname>
<given-names><![CDATA[KD]]></given-names>
</name>
<name>
<surname><![CDATA[Cappola]]></surname>
<given-names><![CDATA[AR]]></given-names>
</name>
<name>
<surname><![CDATA[Celi]]></surname>
<given-names><![CDATA[FS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Guidelines for the treatment of hypothyroidism. Prepared by the American Thyroid Association Task force on thyroid hormone replacement]]></article-title>
<source><![CDATA[Thyroid]]></source>
<year>2014</year>
<volume>24</volume>
<numero>12</numero>
<issue>12</issue>
</nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mathew]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Misgar]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Ghosh]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Mukhopadhyay]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Roychowdhury]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Pandit]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Myxedema coma: a new look into an old crisis]]></article-title>
<source><![CDATA[J Thyroid Res]]></source>
<year>2011</year>
<volume>Disponible</volume>
<publisher-name><![CDATA[7]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rajendran]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bhavani]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Nair]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Pavithran]]></surname>
<given-names><![CDATA[PV]]></given-names>
</name>
<name>
<surname><![CDATA[Menon]]></surname>
<given-names><![CDATA[VU]]></given-names>
</name>
<name>
<surname><![CDATA[Kumar]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Oral levothyroxine is an effective option for myxedema coma: A single-centre experience]]></article-title>
<source><![CDATA[European Thyroid J]]></source>
<year>2021</year>
<volume>10</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>23-9</page-range></nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Orlander]]></surname>
<given-names><![CDATA[PR]]></given-names>
</name>
<name>
<surname><![CDATA[Griffing]]></surname>
<given-names><![CDATA[GT]]></given-names>
</name>
<name>
<surname><![CDATA[Varghese]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Freeman]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypothyroidism treatment &amp; management]]></article-title>
<source><![CDATA[Medscape]]></source>
<year>2021</year>
</nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="book">
<collab>Dirección de Medicamentos y Tecnologías Médicas del Ministerio de Salud Pública</collab>
<source><![CDATA[Cuadro básico de medicamentos y productos naturales 2018. Resolución No. 536]]></source>
<year>2018</year>
<publisher-name><![CDATA[CECMED]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Eghtedari]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Correa]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Levothyroxine]]></article-title>
<source><![CDATA[StatPearls]]></source>
<year>2020</year>
</nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dutta]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Bhansali]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Masoodi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Bhadada]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Sharma]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Rajput]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Predictors of outcome in myxoedema coma: a study from a tertiary care centre]]></article-title>
<source><![CDATA[Critical Care]]></source>
<year>2008</year>
<volume>12</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B33">
<label>33</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hampton]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thyroid gland disorder emergencies: thyroid storm and myxedema coma]]></article-title>
<source><![CDATA[AACN Adv Crit Care]]></source>
<year>2013</year>
<volume>24</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>325-32</page-range></nlm-citation>
</ref>
<ref id="B34">
<label>34</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Builes]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Román]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Memorias Simposio Actualización Endocrinología Médicas UIS 2015. Crisis tiroideas: coma mixedematoso y tormenta tiroidea]]></article-title>
<source><![CDATA[UIS]]></source>
<year>2016</year>
<volume>29</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>84-92</page-range></nlm-citation>
</ref>
<ref id="B35">
<label>35</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rizzo]]></surname>
<given-names><![CDATA[LF]]></given-names>
</name>
<name>
<surname><![CDATA[Mana]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Treatment of hypothyroidism in special situations]]></article-title>
<source><![CDATA[Medicina]]></source>
<year>2020</year>
<volume>80</volume>
<publisher-loc><![CDATA[Arg. ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B36">
<label>36</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[IC]]></given-names>
</name>
<name>
<surname><![CDATA[López]]></surname>
<given-names><![CDATA[PA]]></given-names>
</name>
<name>
<surname><![CDATA[Saavedra]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[NA]]></given-names>
</name>
<name>
<surname><![CDATA[Herrera]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Urgencias endocrinológicas: coma mixedematoso]]></article-title>
<source><![CDATA[Rev Repertorio Med Cirug]]></source>
<year>2021</year>
</nlm-citation>
</ref>
<ref id="B37">
<label>37</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ramírez]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Moranchel]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coma mixedematoso ¿cuándo sospecharlo?]]></article-title>
<source><![CDATA[Aten Fam]]></source>
<year>2019</year>
<volume>26</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>106-8</page-range></nlm-citation>
</ref>
<ref id="B38">
<label>38</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pedroza]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Solarte]]></surname>
<given-names><![CDATA[YA]]></given-names>
</name>
<name>
<surname><![CDATA[Vallejo]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coma mixedematoso e insuficiencia cardíaca. Reporte de un caso clínico]]></article-title>
<source><![CDATA[Rev Mex Endocrinol Metab Nutr]]></source>
<year>2017</year>
<volume>4</volume>
<page-range>188-91</page-range></nlm-citation>
</ref>
<ref id="B39">
<label>39</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rodríguez]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
<name>
<surname><![CDATA[Morcillo]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coma mixedematoso como causa asociada a falla cardíaca de etiología múltiple. Reporte de caso]]></article-title>
<source><![CDATA[Revistas UN]]></source>
<year>2021</year>
<volume>7</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>31-40</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
