A 27-year-old male with primary sclerosing cholangitis and u…
A 27-year-old male with primary sclerosing cholangitis and ulcerative colitis presents with high ileostomy output and abdominal pain for last few weeks associated with a 9-kg weight loss. He has no other medical history. Despite fluid resuscitation and pharmacologic therapy, his symptoms persist. He develops fever to 39.7°C and is transferred to the ICU with concerns for sepsis. On admission to the ICU, he is somnolent and lethargic, heart rate is 160 beats/min, blood pressure is 156/80 mm Hg, respiratory rate is 25/min, and his pulse oximeter reads 98% on room air. His sepsis workup is negative, but his laboratory work is remarkable for a low TSH level. What is the diagnosis?