# A Case of Myxedema Edema in a Patient With Factors XI and XII Deficiency and Sepsis: Unveiling Complications and Management Strategies

## TL;DR

A 77-year-old woman with no history of hypothyroidism developed myxedema coma and was successfully treated with thyroxine and glucocorticoids.

## Contribution

Highlights myxedema coma as a rare but critical condition to consider in hypothermic patients without known hypothyroidism.

## Key findings

- Myxedema coma can occur without prior hypothyroidism history.
- Treatment with thyroxine and glucocorticoids led to a favorable outcome.
- Acute events like sepsis can trigger myxedema coma in hypothyroid patients.

## Abstract

Hypothermic patients are rarely encountered in the emergency department (ED), indicating a potentially critical condition requiring immediate attention and diagnosis. Myxedema coma, a severe complication of hypothyroidism, presents as profound hypothermia and demands early recognition and proper treatment. We report the case of a 77-year-old female with no prior medical history of hypothyroidism. She presented to the ED with a one-and-a-half-month history of weakness, hypothermia, decreased mental status, and edema. Laboratory analysis confirmed hypothyroidism, leading to a diagnosis of myxedema coma. Treatment with thyroxine and glucocorticoid supplements resulted in a favorable outcome without complications. In conclusion, myxedema coma should be considered in hypothermic patients with altered mental status, even without a history of hypothyroidism. Prolonged hypothyroidism or acute events like sepsis, cerebrovascular accidents, gastrointestinal bleeding, cold exposure, trauma, or certain medications can precipitate this condition, emphasizing the need for prompt treatment initiation.