{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T17:09:52Z","timestamp":1779296992103,"version":"3.51.4"},"reference-count":9,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,3,24]]},"abstract":"<jats:p>A 62-year-old man was found to have bradycardia, hypothermia and respiratory failure 3\u2005weeks after initiation of amiodarone therapy for atrial fibrillation. Thyroid-stimulating hormone was found to be 168\u2005\u03bcIU\/mL (nl. 0.3\u20135\u2005\u03bcIU\/mL) and free thyroxine (FT4) was &lt;0.2\u2005ng\/dL (nl. 0.8\u20131.8\u2005ng\/dL). He received intravenous fluids, vasopressor therapy and stress dose steroids; he was intubated and admitted to the intensive care unit. He received 500\u2005\u03bcg of intravenous levothyroxine in the first 18\u2005h of therapy, and 150\u2005\u00b5g intravenous daily thereafter. Haemodynamic improvement, along with complete recovery of mental status, occurred after 48\u2005h. Twelve hours after the initiation of therapy, FT4 was 0.96\u2005ng\/dL. The patient was maintained on levothyroxine 175\u2005(g POorally daily. A thyroid ultrasound showed diffuse heterogeneity. The 24\u2005hour excretion of iodine was 3657\u2005(mcg (25\u2013756\u2005( mcg). The only two cases of amiodarone-induced myxoedema coma in the literature report patient death despite supportive therapy and thyroid hormone replacement. This case represents the most thoroughly investigated case of amiodarone-induced myxoedema coma with a history significant for subclinical thyroid disease.<\/jats:p>","DOI":"10.1136\/bcr-2013-202338","type":"journal-article","created":{"date-parts":[[2014,4,12]],"date-time":"2014-04-12T07:18:05Z","timestamp":1397287085000},"page":"bcr2013202338","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Amiodarone-induced myxoedema coma"],"prefix":"10.1136","volume":"2014","author":[{"given":"Syed","family":"Hassan","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walaa","family":"Ayoub","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Henry Ford Hospital, Detroit, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Max","family":"Wisgerhof","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Henry Ford Hospital, Detroit, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,4,12]]},"reference":[{"key":"2025082805062826000_2014.apr12_1.bcr2013202338.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)91895-3"},{"key":"2025082805062826000_2014.apr12_1.bcr2013202338.2","first-page":"513","article-title":"Pharmacokinetics and body distribution of amiodarone in man","volume":"34","author":"Plomp","year":"1984","journal-title":"Arzneimittelforschung"},{"key":"2025082805062826000_2014.apr12_1.bcr2013202338.3","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-101-1-28"},{"key":"2025082805062826000_2014.apr12_1.bcr2013202338.4","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-62-3-563"},{"key":"2025082805062826000_2014.apr12_1.bcr2013202338.5","doi-asserted-by":"publisher","DOI":"10.1089\/105072501300176453"},{"key":"2025082805062826000_2014.apr12_1.bcr2013202338.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2006.09.003"},{"key":"2025082805062826000_2014.apr12_1.bcr2013202338.7","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(84)90379-6"},{"key":"2025082805062826000_2014.apr12_1.bcr2013202338.8","doi-asserted-by":"publisher","DOI":"10.1210\/endo-45-5-504"},{"key":"2025082805062826000_2014.apr12_1.bcr2013202338.9","first-page":"392","article-title":"Severe congestive heart failure patient on amiodarone presenting with myxedemic coma: a case report","volume":"61","author":"Shaheen","year":"2009","journal-title":"Indian Heart J"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-202338","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:06:34Z","timestamp":1756382794000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-202338"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,12]]},"references-count":9,"alternative-id":["10.1136\/bcr-2013-202338"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-202338","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,12]]}}}