Atypical Thyroid Stimulating Hormone Levels in Myxedema Coma Complicated by Severe Sepsis

Most cases of Myxedema Coma are associated with primary hypothyroidism characterized by significantly elevated thyroid stimulating hormone (TSH) levels. However, this case presents an atypical manifestation of myxedema coma with low TSH levels despite severe hypothyroidism. The rarity of this presentation lies in the absence of central lesions typically responsible for such TSH suppression. This highlights a critical consideration: the profound impact of severe sepsis on thyroid hormone regulation and the hypothalamus-pituitary-thyroid axis.