Refractory Postsurgical Hypothyroidism in Nephrotic Syndrome

A 62-year-old female with a history of thyroid cancer and thyroidectomy experienced worsening edema and hypothyroidism symptoms, including hair loss, despite increasing her thyroid medication. She was diagnosed with severe hypothyroidism exacerbated by nephrotic syndrome due to membranous nephropathy, which caused significant proteinuria. Initial treatment included IV steroids, thyroxine, and diuretics, followed by oral thyroxine and discontinuation of Armour thyroid. Her condition improved with conservative management, and she remained stable on oral thyroxine with outpatient follow-up recommended.