Myopathy in hyperthyroidism as a consequence of rapid reduction of thyroid hormone

Li, Qianrui; Liu, Yuping; Zhang, Qianying; Tian, Haoming; Li, Jianwei; Li, Sheyu

doi:10.1097/md.0000000000007591

Cited by 9 publications

(7 citation statements)

References 25 publications

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“…Hypothyroid myopathy manifests in the setting of hypothyroidism and entails muscle rigidity, cramps and general weakness, pronounced in the extremities [2,56]. Both have also been tied to rhabdomyolysis, especially hypothyroidism, with elevated serum CK enzymes [55], while a similar entity has been described in aggressively-treated hyperthyroidism [57].…”

Section: Endocrine-related Myopathiesmentioning

confidence: 99%

“…In greater detail, a 2015 study on a pediatric population with thyroid disorders showed that impaired overall cognitive function may be tied to hypothyroidism myopathy, with deficits in attention, memory, arithmetic and verbal skills being mainly reported [57]. Mental retardation has also long been associated with severe hypothyroidism and is one of the main reasons as to why neonatal screening is being considered as a standard clinical practice, while the differential diagnosis of acquired cognitive deficits in older individuals typically includes thyroid function tests [58].…”

Section: Endocrine-related Myopathiesmentioning

confidence: 99%

“…Mental retardation has also long been associated with severe hypothyroidism and is one of the main reasons as to why neonatal screening is being considered as a standard clinical practice, while the differential diagnosis of acquired cognitive deficits in older individuals typically includes thyroid function tests [58]. Similarly, individuals with hyperthyroidism and its associated myopathy may also present with altered mental status, emotional instability and confusion [57]. The specific symptoms are classically attributed to increased thyroid function.…”

Section: Endocrine-related Myopathiesmentioning

confidence: 99%

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Cognitive Deficits in Myopathies

Peristeri

Aloizou

Keramida

et al. 2020

IJMS

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Myopathies represent a wide spectrum of heterogeneous diseases mainly characterized by the abnormal structure or functioning of skeletal muscle. The current paper provides a comprehensive overview of cognitive deficits observed in various myopathies by consulting the main libraries (Pubmed, Scopus and Google Scholar). This review focuses on the causal classification of myopathies and concomitant cognitive deficits. In most studies, cognitive deficits have been found after clinical observations while lesions were also present in brain imaging. Most studies refer to hereditary myopathies, mainly Duchenne muscular dystrophy (DMD), and myotonic dystrophies (MDs); therefore, most of the overview will focus on these subtypes of myopathies. Most recent bibliographical sources have been preferred.

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Section: Endocrine-related Myopathiesmentioning

confidence: 99%

Section: Endocrine-related Myopathiesmentioning

confidence: 99%

Section: Endocrine-related Myopathiesmentioning

confidence: 99%

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Cognitive Deficits in Myopathies

Peristeri

Aloizou

Keramida

et al. 2020

IJMS

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“…Previous cases have reported statin-induced hypothyroid myopathy4; myopathy due to relative hypothyroidism resulting from rapid thyroid hormone reduction in a hyperthyroid patient5; and myopathy that resolved with thyroxine administration; however, this patient was clinically euthyroid on presentation and did not have proximal weakness on examination6; a hypothyroid patient with associated myopathy but with a TSH level far lower (50) than the patient in this case report 7. In our case, there was neither statin use nor any other precipitants.…”

Section: Discussionmentioning

confidence: 53%

Severe proximal myopathy secondary to Hashimoto’s thyroiditis

Jervis¹,

Shah

Mongolu

et al. 2019

BMJ Case Rep

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Muscular symptoms in hypothyroidism are common, including myalgia, fatigue and cramps; however, a significantly raised creatine kinase and muscle weakness are rare. Differential diagnosis of patients presenting with muscle weakness and a raised creatine kinase is wide, and hypothyroidism is rarely considered. We report this case of a 30-year-old female presenting with proximal muscle weakness as her primary symptom, hypothyroid symptoms of 3-month duration and a significantly raised creatine kinase. After ruling out other causes of a raised creatine kinase, thyroxine replacement was commenced, which led to complete resolution of her proximal weakness, myalgia and normalisation of creatine kinase level. This case illustrates severe proximal myopathy can be secondary to hypothyroidism, symptoms can resolve with thyroxine replacement and emphasises the importance of measuring thyroid function in patients with proximal weakness/myalgia and a significantly raised creatine kinase.

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“…Previous studies reported that some Graves’ disease patients with oral antithyroid drugs (ATDs) manifested myalgia and increased serum CK levels [ 4 , 5 , 6 , 7 ]. Many patients reported taking ATDs, which were presumed to be the cause of muscular lesions [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Myopathy Associated with Treatment of Graves’ Disease

Kim

2021

Medicina

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Here, we report a case of an increase in serum creatine kinase (CK) concentration in an 11-year-old girl being treated for Graves’ disease with antithyroid drugs (ATDs). The patient complained of myalgia two weeks after methimazole treatment. Triiodothyronine (T3) and free thyroxine (FT4) levels were normal, but the serum CK level was significantly elevated. After switching to propylthiouracil, the serum CK level decreased to normal, and the myalgia was resolved. The development of myopathy during the treatment of hyperthyroidism may be considered as an adverse reaction of MMI. In this report, we present a rare pediatric case, along with a discussion on the possible causes of myopathy that occurred during the treatment of Graves’ disease. A careful follow-up (serum CK levels and thyroid function) and treatment reassessment should always be considered after antithyroid treatment.

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Myopathy in hyperthyroidism as a consequence of rapid reduction of thyroid hormone

Cited by 9 publications

References 25 publications

Cognitive Deficits in Myopathies

Cognitive Deficits in Myopathies

Severe proximal myopathy secondary to Hashimoto’s thyroiditis

Myopathy Associated with Treatment of Graves’ Disease

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