Rhabdomyolysis due to hypothyroidism without any precipitating factor

Abstract

Rhabdomyolysis may develop due to hypothyroidism alone without any precipitating factors, but such reports are rare. We report as such the first manifestation of hypothyroidism.

Rhabdomyolysis Secondary to Hypothyroidism: Report of a Case

“…Symptoms of rhabdomyolysis, though not always present, include muscle pain, weakness, and myoglobinuria; however, the absence of such symptoms should not drive the basis of excluding hypothyroidism as a cause of rhabdomyolysis [5]. Even though precipitants such as drugs (i.e., statins and antibiotics), toxins, infections, and exercise were reported [2,[6][7], patients can have no precipitating factors prior to presentation [4,6,[8][9][10][11][12].…”

“…Furthermore, though rare, rhabdomyolysis can be the only presenting illness of undiagnosed hypothyroidism [6,8,[10][11][12], or in an established case where there is medication non-compliance [2,9]. A prompt diagnosis requires a high index of suspicion, whether in the absence of significant medical history or in a history of hypothyroidism with medications non-adherence, to avoid the detrimental complications of rhabdomyolysis, such as acute renal failure or serious metabolic derangements necessitating the initiation of hemodialysis [7,9,12] or worsening medical condition needing a higher level of care and mechanical ventilation [12]. More importantly, prompt intervention, tackling the hypothyroid aspect of the condition, should be initiated as soon as possible; after which the desired response may only be reached [2,[6][7][8][9][11][12].…”

“…A prompt diagnosis requires a high index of suspicion, whether in the absence of significant medical history or in a history of hypothyroidism with medications non-adherence, to avoid the detrimental complications of rhabdomyolysis, such as acute renal failure or serious metabolic derangements necessitating the initiation of hemodialysis [7,9,12] or worsening medical condition needing a higher level of care and mechanical ventilation [12]. More importantly, prompt intervention, tackling the hypothyroid aspect of the condition, should be initiated as soon as possible; after which the desired response may only be reached [2,[6][7][8][9][11][12]. Also, in patients with established hypothyroidism, where medication non-adherence was not an issue, an increase in thyroxine dose may be necessary to overcome such complications [4].…”

“…Also, in patients with established hypothyroidism, where medication non-adherence was not an issue, an increase in thyroxine dose may be necessary to overcome such complications [4]. The overall prognosis of such complications after the initiation of thyroid replacement therapy is excellent [6][7][8][9][11][12].…”

Rhabdomyolysis Caused by Hypothyroidism: Research Progress

“…Therefore, timely thyroxine supplementation and symptomatic support are keys to treatment. Delayed diagnosis leads to a series of serious complications of RM, such as AKI and severe metabolic disorders that require renal replacement therapy, and further progression of the disease requires a higher level of care and mechanical ventilation [44].…”