Rhabdomyolysis Induced by Nonstrenuous Exercise in a Patient with Graves’ Disease

Sarawut Summachiwakij,Issac Sachmechi

doi:10.1155/2014/286450

Sarawut Summachiwakij, Issac Sachmechi

Open Access

https://doi.org/10.1155/2014/286450

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Abstract

Hyperthyroidism can result in several musculoskeletal conditions such as thyrotoxic periodic paralysis, thyrotoxic myopathy, and thyroid ophthalmopathy. Rhabdomyolysis has been rarely reported to be associated with hyperthyroidism. We describe a 33-year-old man who presented with bilateral thigh pain and dark brown urine after regular squatting. He had a past medical history of hyperthyroidism but stopped taking it 2 months prior to admission. He was found to have rhabdomyolysis, myoglobinuria, and thyrotoxicosis. Presence of thyroid-stimulating immunoglobulins (TSI) and high radioiodine uptake confirmed a diagnosis of Graves' disease. He received aggressive fluid resuscitation and sodium bicarbonate intravenously along with monitoring fluid and electrolyte. Methimazole was also resumed. The patient responded to treatment and rhabdomyolysis gradually resolved. Therefore, nonstrenuous exercise can potentially induce rhabdomyolysis in patients with hyperthyroidism. Although hyperthyroidism is not widely recognized as a cause of rhabdomyolysis, it should be considered in the differential diagnosis of rhabdomyolysis.

Highlights

Rhabdomyolysis is characterized by muscle necrosis resulting in the release of muscle cell content into the circulation
In the English literature, hyperthyroidism has been rarely reported to be associated with rhabdomyolysis [1,2,3,4,5,6]
We have described the case with hyperthyroidism who developed rhabdomyolysis after nonstrenuous exercise

Summary

Introduction

Rhabdomyolysis is characterized by muscle necrosis resulting in the release of muscle cell content into the circulation. In the English literature, hyperthyroidism has been rarely reported to be associated with rhabdomyolysis [1,2,3,4,5,6]. We have described the case with hyperthyroidism who developed rhabdomyolysis after nonstrenuous exercise. The patient often squatted for exercise and never developed rhabdomyolysis.

Results

Conclusion