An Unusual Case of Myxedema Coma

This article presents an unusual case of myxedema coma in a 60-year-old female with primary hypothyroidism, characterized by hair loss, hypothermia, and non-pitting edema. Despite typical cases showing significantly elevated TSH levels, this patient had only mildly elevated TSH due to the impact of severe illness, specifically septic shock from a perforated sigmoid colon. The case highlights how acute illness can disrupt thyroid hormone balance, leading to decreased TSH secretion even without central lesions. Treatment involved Dexamethasone and Levothyroxine, resulting in improved thyroid function. The study underscores the complex hormonal changes during critical illness affecting the HPA axis.