# A Rare Complication of Supraglottic Myxedema Secondary to Hypopituitarism and Hypothyroidism

## TL;DR

A 59-year-old man with hypothyroidism and a history of pituitary adenoma resection developed supraglottic edema, which was successfully managed with intensive care and multidisciplinary treatment.

## Contribution

This case report highlights supraglottic myxedema as a rare complication of hypopituitarism and hypothyroidism, emphasizing the role of multidisciplinary care in treatment.

## Key findings

- Supraglottic edema was observed in a patient with a history of hypothyroidism and pituitary adenoma resection.
- Multidisciplinary treatment led to complete remission of supraglottic edema and associated symptoms.
- Imaging ruled out abscess in deep neck spaces, confirming the diagnosis of supraglottic myxedema.

## Abstract

Supraglottic edemas are rare complications of severe hypothyroidism that present significant challenges in management due to their critical location and acute clinical manifestations. The traditional approach of managing hypothyroidism and airway support has been the preferred treatment in the case of supraglottic edema, while glucocorticoids have a controversial therapeutic benefit. Here, we present a case of a 59-year-old male patient with a history of hypothyroidism and pituitary adenoma resection who presented to the emergency department with stridor and shortness of breath, where he underwent ICU admission, was sedated, and received medical treatments. The pre-ICU fiberoptic evaluation suggested supraglottic edema and congestion of the nasopharynx, and neck imaging revealed an inflammatory process of the right side of the oropharynx and right palatine tonsil and ruled out the presence of an abscess in deep neck spaces. Intensive care unit stay and the multidisciplinary treatments were beneficial, resulting in complete remission of the supraglottic edema and the subsequent symptoms. This case highlights the manifestation of supraglottic edema as a complication of hypothyroidism post pituitary adenoma resection and emphasizes the importance of multidisciplinary collaboration in achieving successful outcomes of these challenging presentations.