Myxedema Coma due to Autoimmune Thyroiditis Presenting as Acute Encephalopathy in an Elderly Male: A Case Report
Abstract: Myxedema coma is a rare but life?threatening manifestation of severe hypothyroidism characterized by altered mental status, hypothermia, bradycardia, and metabolic disturbances. It predominantly occurs in elderly individuals and is associated with high mortality if not recognized early. We report the case of a 65?year?old male who presented with progressive drowsiness and altered sensorium for five days, preceded by a three?month history of constipation, excessive sleepiness, and weight gain. Clinical examination revealed coarse skin, non?pitting edema, hypothermia, bradycardia, and hypoventilation. Laboratory investigations demonstrated severe hypothyroidism with free T3 of 0.30 pg/mL, free T4 of 4.63 ?g/dL, and thyroid?stimulating hormone (TSH) >100 mIU/L. Autoimmune thyroid markers were markedly elevated with anti?thyroid peroxidase antibodies of 484 U/mL and anti?thyroglobulin antibodies of 725 IU/mL, confirming autoimmune thyroiditis. The patient also had hyponatremia and metabolic encephalopathy. Imaging studies did not reveal any structural intracranial pathology. A diagnosis of myxedema coma secondary to Hashimoto thyroiditis was made. The patient was treated with thyroid hormone replacement therapy, hydrocortisone, electrolyte correction, ventilatory support, and vasopressor therapy with gradual improvement in neurological status.
Keywords: Myxedema coma, severe hypothyroidism, Hashimoto thyroiditis, encephalopathy, hyponatremia
How to Cite?: Dr Puratchi Kodi A, "Myxedema Coma due to Autoimmune Thyroiditis Presenting as Acute Encephalopathy in an Elderly Male: A Case Report", Volume 15 Issue 3, March 2026, International Journal of Science and Research (IJSR), Pages: 659-660, https://www.ijsr.net/getabstract.php?paperid=MR26304111814, DOI: https://dx.doi.org/10.21275/MR26304111814