Panhypopituitarism Presenting as Myxedema Coma Unveiling Sheehan's Syndrome

Myxedema coma (MC) is a rare and life-threatening complication of uncontrolled hypothyroidism. We report a 46-year-old Hispanic female who presented with hemodynamic instability and hyponatremia. She was initially diagnosed with adrenal insufficiency (AI). Further evaluation revealed myxedema features and panhypopituitarism, with partial empty Sella. A thorough history was notable for postpartum hemorrhage 18 years prior and followed by failure of lactation and secondary amenorrhea which is consistent with Sheehan's syndrome. Our case highlights the delayed diagnosis of central hypothyroidism with normal thyroid stimulating hormone levels without checking free thyroxine level and emphasizing the importance of comprehensive evaluation in similar presentations.