Thyrotoxic Myopathy

Hed, R.; Kirstein, Lennart; Lundmark, C

doi:10.1136/jnnp.21.4.270

Cited by 51 publications

(18 citation statements)

References 8 publications

(3 reference statements)

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“…Since 1898 a few further reports have appeared. Many described much the same findings as Askanazy (Dudgeon & Urquhart, 1926;Morgan & Williams, 1940;Bartels & Pizer, 1944;Quinn & Worcester, 1951;Bostrom & Hed, 1958;Havard, 1962;Satoyoshi et al, 1963a), but in addition aggregations of lymphocytes, or lymphorrhages, have been noted (Dudgeon & Urquhart, 1926;Liechti, 1938;Thorn & Eder, 1946;Hed et al, 1958;Whitfield & Hudson, 1961). Devic et al (1947) described an alteration of the mitochondria in the region of the motor end-plates and degeneration of muscle mitochondria has recently been observed by Engel (1966) who also noted alterations of the cell surface and of the transverse tubular system.…”

Section: Muscle Pathologymentioning

confidence: 80%

“…Fibrillation was very rarely, and fasciculation never, found (Havard et al, 1963;Ramsay, 1966). Both the patients with fibrillation potentials reported by Hed et al (1958) probably had a lower motor neurone lesion. The shorter action potential duration in myopathies does not occur in disuse atrophy (Buchthal, 1957) and has been attributed to a decrease in the number of fibres in each sub-unit (Buchthai & Rosenfalck, 1963).…”

Section: Muscle Enzymesmentioning

confidence: 98%

“…Millikan & Haines (1953) found normal electro-myograms (EMGs), though since their report Bostrom & Hed (1958), Hed, Kirstein & Lundmark (1958), Whitfield & Hudson (1961) and Havard (1962) have all reported typical myopathic patterns in their patients with clinical thyrotoxic myopathy.…”

Section: Muscle Enzymesmentioning

confidence: 99%

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Thyrotoxic muscle disease

Ramsay¹

1968

Postgraduate Medical Journal

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Summary Evidence suggests that most hyperthyroid patients have a proximal myopathy. The more severe this is the more frequently are distal muscles, and ultimately, bulbar muscles involved. Probably acute thyrotoxic myopathy or encephalopathy supervenes on a previous chronic background or occurs concurrently with skeletal muscle involvement. Using careful electromyographic techniques evidence of myopathy may be found in most thyrotoxics; it disappears with adequate treatment of the primary disease. Myasthenia gravis and periodic paralysis are also associated with thyrotoxicosis and their differentiation is discussed. Infiltrative ophthalmopathy is not related to the effects of excess thyroid hormone, but is possibly due to EPS working in conjunction with LATS.

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Section: Muscle Pathologymentioning

confidence: 80%

Section: Muscle Enzymesmentioning

confidence: 98%

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Thyrotoxic muscle disease

Ramsay¹

1968

Postgraduate Medical Journal

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“…In the past, thyrotoxicosis with significant muscle disorders was classified as a specific disease, thyrotoxic myopathy (Zierler, 1951;Whitfield and Hudson, 1961). However, recently it has been reported that myopathy is common in thyrotoxic patients (Millikan and Haines, 1953;Hed et al, 1958;Ramsay, 1966), and Satoyoshi et al (1963) reported that the skeletal muscles are always more or less impaired in thyrotoxicosis. There have been many reports concerning the abnormal findings of the E.M.G.…”

Section: Discussionmentioning

confidence: 99%

“…There have been many reports concerning the abnormal findings of the E.M.G. (Sanderson and Adey, 1952;Havard et al, 1963;Ramsay, 1965), the pathohistological changes of the muscles (Whitfield and Hudson, 1961;Hed et al, 1958;Engel, 1966;Havard et al, 1963), the biochemical findings such as creatine and creatinine metabolism and serum electrolyte (Satoyoshi et al, 1963;Graig and Smith, 1965;Hoch, 1968), and muscle disorders suggested by the decrease of grasping power and dorsal muscular force (Satoyoshi, 1961;Aoki, 1963) in thyrotoxic myopathy, but there are very few reports concerning the changes in the amount of muscle in thyrotoxicosis. Usually, weight loss is due to loss of lean body mass as well as loss of fat.…”

Section: Discussionmentioning

confidence: 99%

An Evidence for the Decrease of Body Muscle Mass Due to Thyrotoxicosis and Long Term Steroid Therapy by Means of Height, Weight and Upper Arm Circumference Measurements

1972

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SynopsisA weight-corrected UAC of 109 males and 292 females with untreated thyrotoxicosis was compared with that of the same number of control subjects. Control subjects were chosen from the subjects without apparent diseases; one control for one patient with about the same age, height and weight. The mean value of the weight-corrected UAC in thyrotoxic patients was 25.4cm both in males and females. The mean value of the controls was 26.7cm in males and 26.0cm in females. These findings suggest that UAC of thyrotoxic patients is smaller than that of controls even in the same height and weight, and that there is a significant decrease of body muscle mass in thyrotoxic patients.Furthermore, it was suggested that the body muscle mass was decreased in 4 cases which had a long term steroid therapy, because the weight-corrected UAC was smaller than that of the controls.Although it is important to evaluate the degree of muscular wasting in dealing leanness, a simple method for this purpose has not been available. We have previously reported that when upper arm circumference (UAC) is corrected to the standard weight value by lineal regression equation between UAC and body weight expressed as percent deviation from the standard weight, this weight-corrected UAC is a good index of body muscle mass, and that the weight-corrected UAC declines with advancing age.There is a considerable number of studies on thyrotoxic myopathy, but little work has been done to show the change in muscle mass in thyrotoxic patients. In this paper we have attempted to calculate the weight-corrected UAC and evaluate whether body muscle mass of thyrotoxic patients is decreased or not, comparing them with control subjects. Since it is well known that patients with Cushing's syndrome have decreased UAC, an observation about patients who have received long term steroid therapy has also been made in this study. Materials and MethodsThe subjects were untreated patients with thyrotoxic diffuse goiter, 109 males and 292 females. The average age of the male patients was 38 years, including 25 cases aged 20-29, 36 aged 30-39, 33 aged 40-49, and 15 aged 50-59. The average age of the female patients was 35 years, including 105 aged 20-29, 96 aged 30-39, 63 aged 40-49 and 28 aged 50-59. Control subjects were chosen from the subjects without thyrotoxicosis and other apparent diseases; one control for one patient with about the same age, height and weight. UAC was measured at right mid-upper arm in a vertical position. As the standard weight is used the heightweight table, reported preciously (Matsuki and Yoda, 1972). The weight was expressed as percent deviation from the standard weight.

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