<?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>2448-8909</journal-id>
<journal-title><![CDATA[Medicina crítica (Colegio Mexicano de Medicina Crítica)]]></journal-title>
<abbrev-journal-title><![CDATA[Med. crít. (Col. Mex. Med. Crít.)]]></abbrev-journal-title>
<issn>2448-8909</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Medicina Crítica A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-89092016000500342</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Coma mixedematoso y síndrome de Ogilvie asociado a aripiprazol, memantina y venlafaxina. Reporte de caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Myxedema and syndrome Ogilvie associated at aripiprazole, memantine and venlafaxine. Case report]]></article-title>
<article-title xml:lang="pt"><![CDATA[Coma mixedematoso e síndrome de ogilvie associada à aripropazol, memantina e venlafaxina. Relato de caso]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Palacios Moguel]]></surname>
<given-names><![CDATA[Paul]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cepeda Jiménez]]></surname>
<given-names><![CDATA[Miguel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arellano Estrada]]></surname>
<given-names><![CDATA[Juan Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto de Seguridad Social del Estado de México y Municipios (ISSEMyM) Hospital Regional de Tlalnepantla ]]></institution>
<addr-line><![CDATA[ Estado de México]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2016</year>
</pub-date>
<volume>30</volume>
<numero>5</numero>
<fpage>342</fpage>
<lpage>346</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092016000500342&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092016000500342&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092016000500342&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: El coma mixedematoso es la complicación más severa del hipotiroidismo que puede manifestarse en diversos aparatos y sistemas. La etiología más frecuente se asocia a deficiencias nutricionales, inmunológicas, infecciones o fármacos, las claves del diagnóstico son el déficit neurológico y un perfil tiroideo con elevación de la hormona estimulante de la tiroides, en algunas ocasiones es necesaria la intubación orotraqueal por insuficiencia respiratoria. El tratamiento consiste en corregir el déficit hormonal y proporcionar medidas de sostén cuando el paciente se encuentre intubado. Reportamos el caso de un paciente con antecedentes psiquiátricos tratado con antipsicóticos por largo tiempo, el cual inició con un cuadro de oclusión intestinal que fue manejado de manera conservadora; durante su estancia hospitalaria se reinició tratamiento antipsicótico y se presentaron datos de insuficiencia respiratoria, lo que indujo a intubarlo e ingresarlo a la Unidad de Cuidados Intensivos. Durante su estancia se solicitaron enzimas tiroideas, las cuales mostraron elevación de hormona estimulante de tiroides, por lo que se manejó con hormonas tiroideas y esteroides según la literatura actual, con evolución neurológica favorable y protocolo de Weaning exitoso, egresando a las dos semanas posteriores a su ingreso.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: The myxedema is the most severe complication of hypothyroidism that can be manifested in various organs and systems. The most common cause is associated with nutritional deficiencies, immune, infection or drugs, diagnostic keys are neurological deficit and a thyroid profile with elevated thyroid stimulating hormone, sometimes endotracheal intubation for respiratory failure is necessary. The treatment involves correcting the hormonal deficit and give supportive care when the patient is intubated. We report a patient with a psychiatric history treated with anti-psychotic drugs, which debuts with an intestinal occlusion was managed conservatively, while staying anti-psychotic treatment is restarted and presents data of respiratory insufficiency leading to intubate thus entering at Intensive Care Unit. Thyroid enzymes were processed had high titles of Stimulating Hormone Thyroid gave manage thyroid and steroid hormones according to the current literature, evolving favorably neurologically and accomplished Protocol of Weaning succesful, go out two weeks of their income.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: O coma mixedematoso é a complicação mais grave do hipotireoidismo que pode manifestar-se em vários orgão e sistemas. A etiologia mais frequente está associada com deficiências nutricionais, imunológica, infecções ou drogas, o diagnóstico é fortemente determinado pelo déficit neurológico e um perfil de tireóide com elevação do Hormônio Estimulante da Tireóide, em algumas ocasiões é necessário intubação orotraqueal por insuficiência respiratória. O tratamento consiste na correção do défice hormonal e outorgar medidas de apoio quando o paciente está entubado. Relatamos o caso de um paciente com um histórico psiquiátrico tratado com anti-psicóticos por um longo tempo, que debuta com um quadro de obstrução intestinal tratado de manera conservadora, durante sua estadia no hospital se reinicia tratamento anti-psicótico, apresenta dados de insuficiência respiratória que nos leva a entubá-lo, ingresando na unidade de terapia intensiva. Durante sua internação se solicitaram enzimas de tireoidianas que apresentaram elevação do Hormônio Estimulante da Tireóide, pelo que se começa tratamento com hormônios tireoidianos e esteróides de acordo com a literatura atual, evoluindo neurologicamente de manera favorável e protocolo de Weaning bem sucedido, dando-se de alta 2 semanas depois de seu ingresso.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Coma mixedematoso]]></kwd>
<kwd lng="es"><![CDATA[hipotiroidismo]]></kwd>
<kwd lng="es"><![CDATA[síndrome de Ogilvile]]></kwd>
<kwd lng="en"><![CDATA[Myxedema]]></kwd>
<kwd lng="en"><![CDATA[hypothyroidism]]></kwd>
<kwd lng="en"><![CDATA[syndrome Ogilville]]></kwd>
<kwd lng="pt"><![CDATA[Coma mixedematoso]]></kwd>
<kwd lng="pt"><![CDATA[hipotireoidismo]]></kwd>
<kwd lng="pt"><![CDATA[síndrome de Ogilvie]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sara]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Ryan]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypothyroidism Causes, killers, and life saving treatments]]></article-title>
<source><![CDATA[Emerg Med Clin N Am]]></source>
<year>2014</year>
<volume>32</volume>
<page-range>303-17</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Flynn]]></surname>
<given-names><![CDATA[RW]]></given-names>
</name>
<name>
<surname><![CDATA[MacDonald]]></surname>
<given-names><![CDATA[TM]]></given-names>
</name>
<name>
<surname><![CDATA[Morris]]></surname>
<given-names><![CDATA[AD]]></given-names>
</name>
<name>
<surname><![CDATA[Jung]]></surname>
<given-names><![CDATA[RT]]></given-names>
</name>
<name>
<surname><![CDATA[Leese]]></surname>
<given-names><![CDATA[GP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The thyroid epidemiology, audit, and research study thyroid dysfunction in the general population]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2004</year>
<volume>89</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>3879-84</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hollowell]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Staehling]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Flanders]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Hannon]]></surname>
<given-names><![CDATA[WH]]></given-names>
</name>
<name>
<surname><![CDATA[Gunter]]></surname>
<given-names><![CDATA[EW]]></given-names>
</name>
<name>
<surname><![CDATA[Spencer]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Serum TSH, T4, and thyroid antibodies in the United States Population (1988 to 1994) National Health and Nutrition Examination Survey (NHANES III)]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2002</year>
<volume>87</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>489-99</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vaidya]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Pearce]]></surname>
<given-names><![CDATA[SH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Management of hypothyroidism in adults]]></article-title>
<source><![CDATA[BMJ]]></source>
<year>2008</year>
<volume>337</volume>
<page-range>a801</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[Kwaku]]></surname>
<given-names><![CDATA[MP]]></given-names>
</name>
<name>
<surname><![CDATA[Burman]]></surname>
<given-names><![CDATA[KD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Myxedema coma]]></article-title>
<source><![CDATA[J Intensive Care Med]]></source>
<year>2007</year>
<volume>22</volume>
<page-range>224-31</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[Massumi]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Winnacker]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Severe depression of the respiratory center in myxedema]]></article-title>
<source><![CDATA[Am J Med]]></source>
<year>1964</year>
<volume>36</volume>
<page-range>876-82</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[Gupta]]></surname>
<given-names><![CDATA[KJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Myxedema coma a sleeping giant in clinical practice]]></article-title>
<source><![CDATA[Am J Med]]></source>
<year>2013</year>
<volume>126</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>e3-4</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[Gardner]]></surname>
<given-names><![CDATA[DG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Endocrine emergencies]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Gardner]]></surname>
<given-names><![CDATA[DG]]></given-names>
</name>
<name>
<surname><![CDATA[Shoback]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<source><![CDATA[Greenspan's Basic and Clinical Endocrinology]]></source>
<year>2007</year>
<edition>8</edition>
<publisher-loc><![CDATA[New York, NY, USA ]]></publisher-loc>
<publisher-name><![CDATA[McGraw-Hill]]></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[Ladenson]]></surname>
<given-names><![CDATA[PW]]></given-names>
</name>
<name>
<surname><![CDATA[Goldenheim]]></surname>
<given-names><![CDATA[PD]]></given-names>
</name>
<name>
<surname><![CDATA[Ridgway]]></surname>
<given-names><![CDATA[EC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prediction and reversal of blunted ventilatory responsiveness in patients with hypothyroidism]]></article-title>
<source><![CDATA[Am J Med]]></source>
<year>1988</year>
<volume>84</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>877-83</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[Wilson]]></surname>
<given-names><![CDATA[WR]]></given-names>
</name>
<name>
<surname><![CDATA[Bedell]]></surname>
<given-names><![CDATA[GN]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The pulmonary abnormalities in myxedema]]></article-title>
<source><![CDATA[J Clin Invest]]></source>
<year>1960</year>
<volume>39</volume>
<page-range>42-55</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Skowsky]]></surname>
<given-names><![CDATA[WR]]></given-names>
</name>
<name>
<surname><![CDATA[Kikuchi]]></surname>
<given-names><![CDATA[TA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The role of vasopressin in the impaired water excretion of myxedema]]></article-title>
<source><![CDATA[Am J Med]]></source>
<year>1978</year>
<volume>64</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>613-21</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Weirsinga]]></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[Jameson]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Legroot]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
</person-group>
<source><![CDATA[Endocrinology adult and pediatric]]></source>
<year>2010</year>
<edition>6</edition>
<publisher-loc><![CDATA[Philadelphia, Pa. USA ]]></publisher-loc>
<publisher-name><![CDATA[Saunders]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Surks]]></surname>
<given-names><![CDATA[MI]]></given-names>
</name>
<name>
<surname><![CDATA[Sievert]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Drug and thyroid function]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>1995</year>
<volume>333</volume>
<numero>25</numero>
<issue>25</issue>
<page-range>1688-94</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[Church]]></surname>
<given-names><![CDATA[CO]]></given-names>
</name>
<name>
<surname><![CDATA[Callen]]></surname>
<given-names><![CDATA[EC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Myxedema coma associated with combination aripiprazole and sertraline therapy]]></article-title>
<source><![CDATA[Ann Pharmacother]]></source>
<year>2009</year>
<volume>43</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>2113-6</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[Klein]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Ojamaa]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thyroid hormone and the cardiovascular system]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2001</year>
<volume>344</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>501-9</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[Coceani]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Heart disease in patients with thyroid dysfunction hyperthyroidism, hypothyroidism and beyond]]></article-title>
<source><![CDATA[Anadolu Kardiyol Derg]]></source>
<year>2013</year>
<volume>12</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>62-6</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[Arlot]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Debussche]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Lalau]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Mesmacque]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Tolani]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Quichaud]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Myxoedema coma response of thyroid hormones with oral and intravenous high-dose L-thyroxine treatment]]></article-title>
<source><![CDATA[Intensive Care Med]]></source>
<year>1991</year>
<volume>17</volume>
<page-range>16-8</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[Mandel]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Brent]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Larsen]]></surname>
<given-names><![CDATA[PR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Levothyroxine therapy in patients with thyroid disease]]></article-title>
<source><![CDATA[Ann Intern Med]]></source>
<year>1993</year>
<volume>119</volume>
<page-range>492-502</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yamamoto]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Fukuyama]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Fujiyoshi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factors associated with mortality of myxedema coma report of eight cases and literature survey]]></article-title>
<source><![CDATA[Thyroid]]></source>
<year>1999</year>
<volume>9</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1167-74</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[Wall]]></surname>
<given-names><![CDATA[CR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Myxedema coma diagnosis and treatment]]></article-title>
<source><![CDATA[Am Fam Physician]]></source>
<year>2000</year>
<volume>62</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>2485-90</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
