Abstract
Musculoskeletal symptoms are widely recognized manifestations among hypothyroid patients. They are usually mild and insidious, consisting of weakness, cramps, pain, slowness, or stiffness. Although the serum muscle enzymes are increased in most patients with hypothyroidism, true myopathy develops in very few patients. Rarely, a hypothyroid patient with typical proximal muscle weakness and elevated muscle enzymes may be thought to have polymyositis. We report a 48-year-old male with hypothyroidism presenting with hyperlipidemia, hypertension and proximal muscle weakness with elevated muscle enzymes. The initial diagnosis was polymyositis. However, his symptoms and laboratory data improved significantly after treatment with levothyroxine. He had totally recovered by 3 months later. This case illustrates the importance of testing thyroid function in patients with unexplained myopathy or elevated muscle enzymes. If the myopathy is secondary to hypothyroidism, it can be completely reversed with adequate thyroid replacement.
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