Hypothyroidism is one o f the most commo n endo crine disorders world wide. Its prevalence in the developed world is estimated at 4 - 5% 1,2 . A population-based study done in Cochin estimated the prevalence of hypothyroidism and its subclinical form in India at around 3.9% and 9.4% respectively 3 . Because of the advancement in investigations, the disease is usually diagnosed early and a classical case of myxoedema crisis is rarely seen in clinical practice. However, because clinical features of hypothyroidism are similar to those of chronic kidney disease (CKD), its diagnosis may be delayed in patients who have concomitant CKD. We report a case of a 57-year- old male patient admitted with nephrotic syndrome who was d iagnosed with myxoedema crisis during the course of hospitalisation. Myxoedema coma is a classic endocrin e emergency typically p resenting in winters. It represen ts the most extreme form o f hypothyroidism which progresses to death if not diagnosed and treated. Though rare today, it is important to recognise it because of its high mortality and potential reversibility.
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