Rhabdomyolysis Secondary to Hypothyroidism: Report of a Case

Rhabdomyolysis has many causes; however, hypothyroidism is a rare cause of such a condition. Usually, management is similar in many cases, but some exceptions do exist, especially in the case of hypothyroidism. Thus, we reviewed the literature to investigate further precipitant factors, clinical presentations, complications, management, and prognoses. We report a 19-year-old male with a history of hypothyroidism who was brought in for questionable suicidal ideation. Although asymptomatic, he was found to have an acute kidney injury (AKI). Further investigations revealed significantly elevated levels of creatine kinase (CK) and thyroid-stimulating hormone (TSH) in the setting of medication non-compliance. Management with intravenous (IV) fluids and thyroid hormone replacement resulted in an improvement in AKI and CK levels.

Myxedema Coma: a Review

Myxedema coma, represents the extreme degree of severity of hypothyroidism, whose mortality can reach very high percentages, therefore, it is a true medical emergency. In general, its development is associated with the presence of a triggering factor in a controlled hypothyroid patient and manifests with multisystem alteration. Currently, tools have been developed for clinical diagnosis that use the profile and clinical models, and have good sensitivity-specificity. They allow an early diagnosis which favored the early start of treatment and therefore improves the prognosis. The patient with myxedema coma needs an integral approach, with intensive treatment and close monitoring of hemodynamic parameters. However, the basis of treatment remains hormone replacement, which should be initiated with a combination of levothyroxine and triiodothyronine.