Myxedema coma is an extreme manifestation of hypothyroidism. It is characterized by altered mental status and hypothermia. The most common precipitants of myxedema coma include discontinuation of thyroid supplements and infections. Therefore, the mainstay of treatment is IV glucocorticoids and IV levothyroxine. We describe a case of an 81-year-old woman with myxedema coma who developed acute cardiopulmonary failure with associated pericardial and pleural effusions, which are rare manifestations of myxedema coma.

Coronavirus disease 2019 is an infection that involves the respiratory tract and is attributed to severe acute respiratory syndrome coronavirus 2. While most people develop mild or uncomplicated illness, approximately 15% develop a severe disease that requires oxygen support, and 5% develop a critical disease. While immunodeficiency is reported as a risk factor for COVID-19, we present a patient with idiopathic CD4+ lymphocytopenia who developed severe COVID-19 with an unexpected clinical course and complete recovery.

Peritoneal carcinomatosis is most commonly a rare late-stage manifestation of disseminated ovarian cancer. Women with peritoneal carcinomatosis with no obvious primary tumor are presumptively treated for ovarian cancer. However, less frequently, gastrointestinal cancer disseminates to the peritoneum, which would confer other treatment options. Herein, we present a case of a 68-year-old woman who was managed for peritoneal carcinomatosis of metastatic mucinous adenocarcinoma of lower gastrointestinal origin.