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Case Reports
. 2017 Jul;96(30):e7591.
doi: 10.1097/MD.0000000000007591.

Myopathy in hyperthyroidism as a consequence of rapid reduction of thyroid hormone: A case report

Qianrui Li  1 , Yuping Liu, Qianying Zhang, Haoming Tian, Jianwei Li, Sheyu Li
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Free PMC article
Case Reports

Myopathy in hyperthyroidism as a consequence of rapid reduction of thyroid hormone: A case report

Qianrui Li et al. Medicine (Baltimore). 2017 Jul.
Free PMC article

Abstract

Rationale: Myalgia and elevated creatine kinase (CK) are occasionally observed during the treatment of hyperthyroid patients. Relative hypothyroidism resulted from rapid thyroid hormone reduction had been promoted as a plausible cause of these myopathic changes, however rarely reported.

Patient concerns: We hereby presented a 20-year-old female with Grave's disease, who developed myopathy and elevated CK during rapid correction of thyroid hormone.

Diagnoses: Relative hypothyroidism-induced myopathy.

Interventions: Antithyroid drug (ATD) dosage was reduced without levothyroxine replacement.

Outcomes: The muscular symptoms were recovered with CK level returned to normal after adoption of the euthyroid status.

Lessons: Differentiation of relative hypothyroidism from other causes of myopathy, especially with the effect of ATD, is important for clinical practice, although difficult in many cases.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Clinical course of the disease, including prescription, myalgia, and serum levels of thyroxine and creatine kinase. CK = creatine kinase, FT4 = free thyroxine, PTU = propylthiouracil.
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