Sorely Mistaken-Soft Palatal Myxedema in Decompensated Hypothyroidism Presenting as a Sore Throat: Case Report

Oropharyngeal myxedema is a rare presenting symptom of decompensated hypothyroidism that can mimic more common causes of sore throat.

We describe a case of an older woman who presented with throat pain and dysphagia, found to have soft palate edema on exam and imaging. Laboratory testing confirmed severe hypothyroidism, and her symptoms eventually resolved with thyroid hormone replacement therapy.

This case highlights a rare and under-recognized presentation of a common endocrine disorder. Consider myxedema from severe hypothyroidism in patients with subacute oropharyngeal pain and swelling. Without early recognition and treatment, the patient is at risk for two life-threatening conditions: airway compromise from soft palate myxedema and progression of hypothyroidism to myxedema coma.