# Supraglottic Myxedema Presenting as a Complication of Hypothyroidism: A Case Report

## TL;DR

A middle-aged woman with severe hypothyroidism developed life-threatening complications including airway swelling and pneumonia, ultimately leading to her death.

## Contribution

This case report highlights supraglottic myxedema as a rare and severe complication of hypothyroidism.

## Key findings

- The patient presented with severe hypothyroidism and polyserositis, leading to extensive soft tissue edema and airway narrowing.
- Despite initial treatment with levothyroxine and antibiotics, the patient developed ventilator-associated pneumonia and respiratory failure.
- The case underscores the potential severity and mortality risk of untreated or inadequately managed hypothyroidism.

## Abstract

Myxedema is a medical emergency with high mortality rates if not treated aggressively. Here, we present a middle-aged female with complaints of generalized body swelling for one year, shortness of breath, hoarseness of voice, neck swelling, and cough for 20 days. The patient was diagnosed to be having severe hypothyroidism with polyserositis. Contrast-enhanced computed tomography (CECT) of the neck and thorax revealed extensive soft tissue edema causing airway narrowing, bilateral pleural effusion, moderate pericardial effusion, and features of atypical pneumonia. The patient was started on levothyroxine and antibiotics as per cultures to which she had initially improved; however, she developed ventilator-associated pneumonia leading to sepsis, acute respiratory distress syndrome followed by refractory type 1 respiratory failure and succumbed.