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2017 ; 18
(ä): 912-918
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Rhabdomyolysis in a Patient with Severe Hypothyroidism
#MMPMID28827517
Salehi N
; Agoston E
; Munir I
; Thompson GJ
Am J Case Rep
2017[Aug]; 18
(ä): 912-918
PMID28827517
show ga
BACKGROUND Muscular symptoms, including stiffness, myalgia, cramps, and fatigue,
are present in the majority of the patients with symptomatic hypothyroidism, but
rhabdomyolysis, the rapid breakdown of skeletal muscle, is a rare manifestation.
In most patients with hypothyroidism who develop rhabdomyolysis, precipitating
factors, such as strenuous exercise or use of lipid-lowering drugs, can be
identified. CASE REPORT We report a case of a 52-year-old Hispanic woman with a
history of hypothyroidism, hypertension, and type 2 diabetes mellitus who
presented with fatigue, severe generalized weakness, bilateral leg pain, and
recurrent falls. She reported poor medication compliance for the preceding month.
Initial laboratory testing showed elevated thyroid stimulating hormone (TSH) and
creatine kinase (CK) levels, indicating uncontrolled hypothyroidism with
associated rhabdomyolysis. Supportive treatment with intravenous fluids and
intravenous levothyroxine were initiated and resulted in dramatic clinical
improvement. CONCLUSIONS We report a case of rhabdomyolysis, which is a rare but
potentially serious complication of hypothyroidism. Screening for hypothyroidism
in patients with elevated muscle enzymes should be considered, since an early
diagnosis and prompt treatment of hypothyroidism is essential to prevent
rhabdomyolysis and its consequences.