# A Case Report of Myxedema Coma in the Setting of Normal Thyroid Stimulating Hormone

## TL;DR

This case report describes a rare instance of myxedema coma with normal TSH levels, highlighting the importance of clinical diagnosis in hypothyroidism.

## Contribution

The novelty lies in presenting a myxedema coma case with normal TSH, challenging typical diagnostic criteria.

## Key findings

- Myxedema coma can occur with normal thyroid stimulating hormone (TSH) levels.
- Free thyroxine (FT4) was only mildly decreased in this severe case.
- Clinical diagnosis is crucial even when hormone levels appear normal.

## Abstract

Myxedema coma (MC) is a potentially fatal complication of hypothyroidism, with a high mortality rate. It is a clinically diagnosed condition, where the symptoms are related to decreased metabolic effects due to low active thyroid hormones. This case report highlights a severe case of MC, despite the thyroid stimulating hormone (TSH) being normal and the free thyroxine (FT4) being very mildly decreased.