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ARTICLE |

Coexistence of Cirrhosis, Myxedema, and Fatal Coma

LEWIS E. BRAVERMAN, M.D.; STEPHEN H. ROBINSON, M.D.
Arch Intern Med. 1961;107(3):375-379. doi:10.1001/archinte.1961.03620030063008.
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Report of a Case  The similarity of the mental abnormalities in severe myxedema and impending hepatic coma and the possibility that the stigmata of one disease may be modified by the coexistence of the other makes the differential diagnosis difficult. Myxedema coma and hepatic coma may run a parallel and progressive course unless proper therapy is immediately instituted. The concurrence of severe myxedema and severe cirrhosis in an elderly woman illustrating these problems in diagnosis and treatment prompted us to report this case.

Report of Case  First Admission (Jan. 31-March 21, 1959).— The patient, a 79-year-old white spinster, was admitted to the Boston City Hospital because of mental deterioration. Retrospectively, some hoarseness, deafness, and cold sensitivity had been present over recent months. Over the month prior to admission, fatigue, weakness, and somnolence were noted. About 3 weeks prior to admission, she was noted to be intermittently incoherent, especially at

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