Hypothyroidism Induced Severe Rhabdomyolysis in a Hemodialysis Patient

Tatar, Erhan; Isikyakar, Tolgay; Yeniay, Kezban Pınar; Uzuner, Hasan Huseyin; Ok, Ebru Sevinç

doi:10.1155/2014/501890

Cited by 6 publications

(3 citation statements)

References 21 publications

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“…However, hypothyroidism is a non-traumatic and uncommon cause of this disease. Therefore, the exact association between rhabdomyolysis and hypothyroidism is still not clear ( Satarasinghe et al, 2007 ; Tatar et al, 2014 ; Sindoni et al, 2016 ). The influence of THs on mitochondrial activity seems to be a possible correlation.…”

Section: Thyroid Hormones and Myopathiesmentioning

confidence: 99%

Thyroid Hormones Play Role in Sarcopenia and Myopathies

et al. 2018

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Skeletal muscle maintains posture and enables movement by converting chemical energy into mechanical energy, further contributing to basal energy metabolism. Thyroid hormones (thyroxine, or T4, and triiodothyronine, or T3) participate in contractile function, metabolic processes, myogenesis and regeneration of skeletal muscle. T3 classically modulates gene expression after binding to thyroid hormone nuclear receptors. Thyroid hormone effects depend on nuclear receptor occupancy, which is directly related to intracellular T3 levels. Sarcolemmal thyroid hormone levels are regulated by their transport across the plasma membrane by specific transporters, as well as by the action of deiodinases types 2 and 3, which can activate or inactivate T4 and T3. Thyroid hormone level oscillations have been associated with the worsening of many myopathies such as myasthenia gravis, Duchenne muscular dystrophy (DMD) and rhabdomyolysis. During aging skeletal muscle show a decrease in mass and quality, known as sarcopenia. There is increasing evidence that thyroid hormones could have a role in the sarcopenic process. Therefore, in this review, we aim to discuss the main effects of thyroid hormones in skeletal muscular aging processes and myopathy-related pathologies.

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Section: Thyroid Hormones and Myopathiesmentioning

confidence: 99%

Thyroid Hormones Play Role in Sarcopenia and Myopathies

et al. 2018

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“…Among the muscle disorders noted with hypothyroidism, rhabdomyolysis is the most serious disorder. [ 7 , 8 ] Rhabdomyolysis associated with hypothyroidism has been described as early as 1979. [ 9 ] There have been earlier case reports regarding rhabdomyolysis as the initial presentation of hypothyroidism.…”

Section: Discussionmentioning

confidence: 99%

An interesting case of hypothyroidism associated acute kidney injury

et al. 2023

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Muscle involvement is common in hypothyroidism. However, hypothyroidism as a causal factor for severe rhabdomyolysis and acute kidney injury (AKI) is rarely reported. We report a case of a 56-year-old Arab male who presented with unexplained acute worsening of chronic kidney disease. The patient was detected to have hypothyroidism and rhabdomyolysis on laboratory investigations. However, thyroxine replacement led to partial recovery of renal function. CPK also improved with vigorous hydration and thyroxine replacement. Although this is a rare association, in the absence of other causes of rhabdomyolysis, hypothyroidism should be suspected in patients presenting with AKI and high creatinine phospho-kinase.

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“…Rhabdomyolysis, the rapid breakdown of skeletal muscle, may also develop due to hypothyroidism [ 2 – 10 , 18 , 22 ]. Myolysis in hypothyroidism is caused by changes in muscle fibers from fast-twitching type II to slow-twitching type-I fibers, deposition of glycosaminoglycan, poor contractility of actin-myosin units, low myosin ATPase activity, and low ATP turnover in the skeletal muscles [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Rhabdomyolysis in a Patient with Severe Hypothyroidism

et al. 2017

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Patient: Female, 52Final Diagnosis: Hypothyroidism induced rhabdomyolysisSymptoms: Bilateral leg pain • fatigueMedication: Levothyroxine • Calcitriol • Calcium GluconateClinical Procedure: —Specialty: Endocrinology and MetabolicObjective:Unusual clinical courseBackground: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.

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Hypothyroidism Induced Severe Rhabdomyolysis in a Hemodialysis Patient

Cited by 6 publications

References 21 publications

Thyroid Hormones Play Role in Sarcopenia and Myopathies

Thyroid Hormones Play Role in Sarcopenia and Myopathies

An interesting case of hypothyroidism associated acute kidney injury

Rhabdomyolysis in a Patient with Severe Hypothyroidism

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