Myxedema coma presenting as reversible pancytopenia

Pancytopenia is defined as a reduction in red blood cells, white blood cells, and platelets and remains a diagnostic challenge due to the multitude of causes. Myxedema coma is the manifestation of severe untreated hypothyroidism. This case report presents a rare instance of myxedema coma-associated pancytopenia in a 72-year-old male without any history of hypothyroidism. The patient presented with altered mental status, unstable vital signs, and was found to have pancytopenia. During the treatment course, hypothyroidism was identified, and he was treated with oral levothyroxine, intravenous hydrocortisone, and supportive care. The patient’s clinical status improved gradually, with normalized blood counts upon discharge. This case underscores the significance of considering myxedema coma in the differential diagnosis of pancytopenia, especially in older patients with limited healthcare access.