Abstract
We report the case of a 33-year-old male with hypothyroidism who developed acute renal impairment with rhabdomyolysis after strenuous physical activity (snow shoveling). His thyroid function test confirmed marked hypothyroidism. Severe elevation of serum CK consistent with rhabdomyolysis was noted and an elevated creatinine indicated acute renal impairment. Patient's condition improved significantly after starting him on thyroid hormone replacement therapy and aggressive hydration. Acute renal impairment with rhabdomyolysis in patients with hypothyroidism is quite rare and we expect that this case report adds to the existing literature on this subject. We also emphasize that thyroid status should be evaluated in patients with unexplained acute renal impairment and presenting with the symptoms of muscle involvement.
Highlights
The effects of hypothyroidism on the renal function are fairly well established
Another mechanism that can explain renal dysfunction in hypothyroidism is the influence that thyroid hormones have on tubular secretion of creatinine
Muscle disorders and other muscular manifestations are common with hypothyroidism as creatinine production in muscles is dependent on thyroid status
Summary
The effects of hypothyroidism on the renal function are fairly well established These effects include histological changes as well as physiological changes. The changes to renal functions are subtle in most patients with hypothyroidism and are often overlooked in clinical setting. This association is often inferred when patient’s renal impairment is improved by thyroid hormone replacement therapy. Muscle disorders and other muscular manifestations are common with hypothyroidism These muscular manifestations may range from mere stiffness, weakness, or elevated creatinine phosphokinase to more serious manifestations such as Hoffman’s syndrome or rhabdomyolysis [2, 3]. We report the case of a 33-year-old male with hypothyroidism who developed acute renal impairment with rhabdomyolysis. This case report joins the list of the selected few case reports that reported hypothyroid acute renal impairment along with the association of rhabdomyolysis
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