An Unusual Case of Myxedema Coma

This case study describes a 60-year-old female with myxedema coma, characterized by hypothermia, hair loss, and other symptoms, but with only mildly elevated TSH levels, contrary to typical cases of primary hypothyroidism. Despite the absence of central lesions, the patient had elevated anti-TPO antibodies and atrophic thyroid lobes, indicating primary hypothyroidism. Her condition was complicated by septic shock from a perforated sigmoid colon. Treatment involved Dexamethasone and IV Levothyroxine, transitioning to oral Synthroid, which improved her thyroid function. The study highlights that acute illnesses like sepsis can disrupt TSH secretion due to inflammatory cytokines, affecting thyroid hormone balance even without central hypothyroidism.