What are the key clinical features to identify a patient in myxoedema coma?

Key clinical features used to identify a patient with myxoedema coma include:

• Profound hypothermia, often with body temperature below 35°C.
• Altered mental status ranging from lethargy and confusion to coma.
• Bradycardia and hypotension reflecting cardiovascular depression.
• Respiratory depression leading to hypoventilation and hypercapnia.
• Non-pitting oedema, particularly facial and peripheral, characteristic of severe hypothyroidism.
• Dry, coarse skin and hair thinning or loss.
• Hyponatraemia and hypoglycaemia as metabolic disturbances.
• Reduced reflexes and sometimes seizures due to central nervous system involvement.

These features reflect the severe decompensation of hypothyroidism and multi-organ dysfunction seen in myxoedema coma, which is a rare but life-threatening endocrine emergency ¹ (Spitzweg et al., 2017; De Sanctis et al., 2021).