Myxedema Coma, A Forgotten Clinical Entity in Medical Emergency: A Case Report

Authors

  • Shambhu Khanal Lumbini Provincial Hospital, Nepal https://orcid.org/0000-0002-1247-7389
  • Savita Aryal Universal College of medical sciences, Bhairahawa, Lumbini Province, Nepal
  • Buddha Rayamajhi Bhim Hospital, Bhairahawa, Lumbini Province, Nepal https://orcid.org/0000-0002-5743-3320
  • Rohit Shrestha Lumbini Provincial Hospital, Butwal, Lumbini Province, Nepal
  • Nandu Pathak Lumbini Provincial Hospital, Butwal, Lumbini Province, Nepal

DOI:

https://doi.org/10.59779/jiomnepal.1431

Keywords:

Myxedema coma, levothyroxine, drowsiness, thyroid function test

Abstract

Myxedema coma is a rare endocrine emergency and is often forgotten differential diagnosis in a patient with altered mental status. Despite its rare occurrence, clinical suspicion is needed in any patient with clinical features and biochemical evidence of hypothyroidism. It ideally requires intravenous levothyroxine for treatment. We report a case of 76 year old male, nonsmoker, non-alcohol consumer who presented with acute onset altered mental status and stupor, which was attributed to untreated severe hypothyroidism and successfully treated with oral levothyroxine despite unavailability of its intravenous form.

Author Biographies

  • Shambhu Khanal, Lumbini Provincial Hospital, Nepal

    Shambhu Khanal, M.D (Internal Medicine), Consultant Physician

    Department of Internal Medicine, Butwal, Lumbini Provincial Hospital, Nepal

  • Savita Aryal, Universal College of medical sciences, Bhairahawa, Lumbini Province, Nepal

    Resident

    Department of otorhinolaryngology

  • Buddha Rayamajhi, Bhim Hospital, Bhairahawa, Lumbini Province, Nepal

    Consultant Dermatologist

    Department of Dermatology 

Published

2026-04-30

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