P-098 MYXEDEMA COMA PRESENTING WITH PERICARDIAL EFFUSION: A CASE REPORT

Abstract Introduction Myxedema coma is a rare but life-threatening endocrine emergency caused by long-standing untreated severe hypothyroidism. It is characterized by altered mental status, hypothermia, bradycardia, and hypotension. Mortality has been reported between 20% and 50%. Early recognition and rapid thyroid hormone replacement, along with supportive management, are crucial for improving survival. Standard treatment includes high-dose intravenous levothyroxine and stress-dose glucocorticoids due to the risk of concomitant adrenal insufficiency. Clinical Case A 32-year-old male presented to the emergency department with complaints of vomiting, numbness in the hands and feet, and chest pain. He had a history of Hashimoto’s thyroiditis and had discontinued his daily 100 µg levothyroxine treatment in recent months. On admission, his body temperature was 36.3 °C, blood pressure 88/53 mmHg, and heart rate 43 bpm. Electrocardiography revealed sinus bradycardia. No obivous edema was detected on physical examination. Laboratory tests demonstrated TSH 433 µIU/mL, free T4