Sahoo Jayaprakash, Veerappan Ilangovan, Abraham Anila, Hariharan Somasundaram
Department of Endocrinology, Pondicherry Institute of Medical Sciences, Puducherry 605014, India.
Case Rep Endocrinol. 2012;2012:237563. doi: 10.1155/2012/237563. Epub 2012 Dec 10.
We describe a patient with type 2 diabetes mellitus and autoimmune hypothyroidism who presented with elevated serum creatinine possibly due to subclinical rhabdomyolysis induced by hypolipidemic drug therapy in the background of diabetic nephropathy. Both hypothyroidism and rhabdomyolysis were asymptomatic in this case as evidenced by lack of classical clinical features of hypothyroidism despite elevated serum TSH and absent pigment cast in renal biopsy. The combination of diabetes mellitus and hypothyroidism is common in the general population and should not be forgotten in patients with diabetes and kidney disease.
我们描述了一名患有2型糖尿病和自身免疫性甲状腺功能减退症的患者，其血清肌酐升高，可能是由于在糖尿病肾病背景下，降脂药物治疗诱发的亚临床横纹肌溶解所致。在该病例中，甲状腺功能减退症和横纹肌溶解均无症状，尽管血清促甲状腺激素升高，但缺乏甲状腺功能减退症的典型临床特征，且肾活检未见色素管型，可证明这一点。糖尿病和甲状腺功能减退症在普通人群中很常见，糖尿病和肾病患者不应忽视这一点。
