Queen Anne Sign in a 72-Year-Old Man with Hypothyroidism

A 72-year-old man with a history of hypothyroidism presented with symptoms including fatigue, cold intolerance, and loss of the outer third of his eyebrows, known as the Queen Anne sign. He had discontinued levothyroxine 6 months prior, leading to severe hypothyroidism, evidenced by elevated thyrotropin levels and undetectable thyroid hormones. Despite concerns for myxedema coma, psychiatric evaluation did not support this, and his condition improved with oral thyroid hormone replacement. The Queen Anne sign, though uncommon, was attributed to his hypothyroidism. Severe hypothyroidism is rare in Canada due to accessible testing and treatment, but if untreated, it can lead to serious complications.