Myxedema Coma in a Hypothermic, Obtunded Patient with Post-renal Acute Kidney Injury and Bacteremia in the Intensive Care Unit
Bibliographic record
Abstract
We present a case of a hypothermic, unconscious patient transferred to our Intensive Care Unit with sepsis requiring mechanical ventilation. The absence of any known past medical history as well as concurrent obstructive uropathy and bacteremia made initial diagnosis challenging. He was eventually found to be in myxedema coma in light of evolving signs and laboratory investigations. This case emphasizes the need to consider myxedema coma in the differential diagnosis of profound hypothermia, especially when other clinical signs and symptoms may obscure its initial diagnosis, and lead clinicians to focus on the triggering event in isolation rather than concurrently managing hypothyroidism. This case highlights a challenging presentation of an uncommon, but life-threatening condition. We discuss the signs and symptoms present in the hypothyroid patient with myxedema coma; emphasize the pathophysiology of myxedema coma as well as the evidence-based acute management of this condition.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".