Surprising Diagnosis of Myxedema Crisis In-Patient Who Presented With Altered Sensorium

Hypothyroidism, a disorder of decreased thyroid hormone secretion diagnosed by increased thyroid stimulating hormone (TSH) and low free triiodothyronine (FT3) and free thyroxine (FT4) levels, is classified as primary and secondary hypothyroidism, depending on the pathology. Raised TSH levels are associated with primary hypothyroidism, while decreased levels of TSH are seen in secondary hypothyroidism. With the easy availability of diagnostic tests, hypothyroidism can be detected and managed early but can be life-threatening if not treated within time. Manifestations of hypothyroidism are dry skin, hoarseness of voice, weight gain, constipation, cold intolerance, fatigue, and lethargy; however, the clinical presentation can differ as per age and sex and person to person. Here, we present one such case, which was brought to the emergency room with a history of altered sensorium, hypotension, and swelling over the bilateral lower limbs and face, with a surprise diagnosis of myxedema crisis. The uniqueness of this case is the omnipresent availability of early diagnosis and treatment in this era. still got a female patient with altered sensorium who was diagnosed to be a myxedema crisis which was given a lesser thought in our provisional diagnosis.