Hoffmann Syndrome, Manifestation of Hypothyroidism: Case Report

Abstract

Hoffmann syndrome is defined since 1897 as the combination of hypothyroidism with myopathy, mioedema, rigidity, muscle cramps, and hypertrophy. The objective of this publication is to describe a typical case of thyroid disease with clinical, hormonal, and muscular characteristics of a Hoffmann syndrome, as an exceptional manifestation of hypothyroidism. The clinical challenge consisted in linking the apparent ambiguity of the clinical symptoms such as: generalized weakness, fatigue, muscle cramps in a young patient, without personal record of previous disease, apparently healthy and well-nourished with favorable muscle development. Additionally, manifestation of pituitary gland dysfunction was found, such as headache and galactorrhea, bibliography reviewed showed mainly, male patients patter and not any comment concerning hypophysis impairment. all clinical manifestations disappeared after replacement treatment with levothyroxine, including the goiter and pituitary macroadenoma. The management of the case involved a multidisciplinary team and involved internists, cardiologist, endocrinologists, radiologist, and neurosurgeons. This form of thyroid myopathy is rare and usually accompanies adult patients with severe and long-standing hypothyroidism, is different from those that begin in early childhood and are associated with cretinism and muscle hypertrophy.