J Korean Soc Endocrinol.  2005 Aug;20(4):381-384. 10.3803/jkes.2005.20.4.381.

A Case of Thyrotoxicosis Presented as Rhabdomyolysis

• Hyun YS
• Lee CB
• Park YS
• Kim DS
• Choi WH
• Kim TW
• Ahn YH

• KMID: 2100469
• DOI: http://doi.org/10.3803/jkes.2005.20.4.381

Abstract

There have been a few reports on rhabdomyolysis caused by thyroid storm, but no cases of thyrotoxicosis related rhabdomyolysis have been reported until now. Here, a rare case of rhabdomyolysis, accompanied by thyrotoxicosis, is reported. A 21-year-old man was admitted to our hospital with severe pain and weakness in both legs. The initial laboratory findings revealed a high muscle enzyme level and severe hypokalemia. In evaluation of the rhabdomyolysis, the thyroid function test was compatible with that of Graves' disease, with the rhabdomyolysis subsequently diagnosed, presenting as thyrotoxicosis. The possible mechanisms for this complaint were hypokalemia-induced muscle ischemia, a thyrotoxicosis-induced excessive hypermetabolic state and pressure-induced muscle ischemia. Therefore, the work up for the cause of rhabdomyolysis should include thyrotoxicosis. The management of rhabdomyolysis is hydration, prevention of acute renal failure, correction of aggravating factors and treatment of the underlying cause, for example, thyrotoxicosis.

MeSH Terms

Acute Kidney Injury
Graves Disease
Humans
Hypokalemia
Ischemia
Leg
Rhabdomyolysis*
Thyroid Crisis
Thyroid Function Tests
Thyrotoxicosis*
Young Adult

Figure

• 

  Fig. 1 Changes of serum potassium and muscle enzyme levels. The muscle enzymes rapidly decreased to normal range, and potassium level suddenly decreased on 8th hospital day in spite of supplementation.

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