Management of endocrine emergencies: joint consensus statement for management of myxoedema coma

Myxoedema coma is a rare, life-threatening endocrine emergency resulting from severe hypothyroidism, most commonly affecting older adults. It is characterised by altered mental status, hypothermia, and multiorgan dysfunction, with a high mortality rate if not promptly recognised and treated. This consensus statement provides recommendations for the diagnosis, initial resuscitation, and definitive management of myxoedema coma based on clinician expertise and experience. Key elements include early recognition of precipitating factors, the use of early empiric stress dose glucocorticoids, supportive care in a high-dependency or intensive care setting, and cautious thyroid hormone replacement. Guidance is also given on ventilatory and circulatory support, correction of electrolyte and metabolic disturbances, and monitoring of therapy. The document emphasises a structured approach to diagnosis and management to improve outcomes in this rare but critical condition.