Acute Flaccid Paralysis in an 11-Year-Old

Abstract

Rhabdomyolysis is a syndrome caused by injury to skeletal muscle and subsequent release of intracellular components into the systemic circulation. We report a case of rhabdomyolysis causing acute paralysis from underlying and unrecognized hypothyroidism in an 11-year-old girl. To date, publications of rhabdomyolysis secondary to hypothyroidism have been limited, especially in the pediatric population. Early intervention with intravenous fluids and levothyroxine led to resolution of our patient's symptoms and is overall important in preventing the serious sequela of rhabdomyolysis including renal failure, cardiac dysrhythmias, compartment syndrome, and disseminated intravascular coagulation.

Rhabdomyolysis: A Rare Presentation of Hashimoto Thyroiditis in an Adolescent Boy and Review of the Literature

“…Acyl carnitine and carnitine profiles were normal, ruling out a metabolic myopathy. We identified 6 additional published cases (5 of whom were girls) of rhabdomyolysis in children with profound hypothyroidism and Hashimoto thyroiditis [2,[4][5][6][7][8], including two toddlers who presented with severe myopathy [9,10]. In all but 1 case, rhabdomyolysis was the presenting feature and TSH levels were strikingly high.…”

Rhabdomyolysis Caused by Hypothyroidism: Research Progress

“…Fewer than 10 % of patients exhibit the classical triad, and up to 50 % of patients do not have any symptoms [6]. RM can also cause a range of complications, including renal failure, hypovolemia, cardiac arrhythmias, osteofascial compartment syndrome, severe electrolyte disturbances, and diffuse intravascular coagulation [7,8]. When these severe complications occur in combination, the mortality rate increases significantly.…”