Baral Bidisha, Parajuli Sandesh R, De Nieva Harvey B, Wagle Laxman, Pant Hom Nath
Internal Medicine, Ascension Saint Agnes Hospital, Baltimore, USA.
Internal Medicine, Tower Health Reading Hospital, Reading, USA.
Cureus. 2024 Sep 19;16(9):e69715. doi: 10.7759/cureus.69715. eCollection 2024 Sep.
Rhabdomyolysis is a rare but serious complication of hypothyroidism, typically associated with precipitating factors such as medication interactions, strenuous exercise, and illicit drug use. We present a unique case of rhabdomyolysis in an 89-year-old female due to severe hypothyroidism without identifiable precipitating factors. Laboratory results revealed markedly elevated creatine kinase (CK) levels and acute kidney injury (AKI). The diagnosis was confirmed by critically elevated thyroid-stimulating hormone (TSH) and low free thyroxine (FT4) levels. Prompt initiation of levothyroxine supplementation and fluid resuscitation led to clinical improvement and downward trend in creatinine and CK levels. This case highlights the importance of considering hypothyroidism in the differential diagnosis of rhabdomyolysis and the need for timely T4 supplementation and supportive care to prevent severe complications.
横纹肌溶解症是甲状腺功能减退症一种罕见但严重的并发症，通常与药物相互作用、剧烈运动和使用非法药物等诱发因素有关。我们报告了一例89岁女性因严重甲状腺功能减退症导致横纹肌溶解症的独特病例，该病例无明确的诱发因素。实验室检查结果显示肌酸激酶（CK）水平显著升高以及急性肾损伤（AKI）。促甲状腺激素（TSH）极度升高和游离甲状腺素（FT4）水平降低确诊了该疾病。及时开始补充左甲状腺素和液体复苏使临床症状得到改善，肌酐和CK水平呈下降趋势。该病例强调了在横纹肌溶解症的鉴别诊断中考虑甲状腺功能减退症的重要性，以及及时补充T4和给予支持性治疗以预防严重并发症的必要性。
