Author/Editor		Bedernjak-Bajuk, Nataša; Rot, Uroš; Hojker, Sergej
Title		Miopatija ob hudi hipotirozi
Translated title		Severe hypothyrosis presenting as myopathy
Type		članek
Source		In: Bručan A, Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja. Zbornik 12. mednarodni simpozij o urgentni medicini; 2005 jun 15-18; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		2005
Language		slo
Abstract		Background: We report a case of a 41-year old man who one year before admission observed a progressive weakness of both arms and legs with stiffness and pins and needles in his hands. He became forgetful and he fatigued easily. His voice became hoarse. On clinical examination his heart rate was 55/min with low heart sounds. The skin was dry and thick. Laboratory findings are as follows: creatine phosphokinase 32.11 ukat/L (up to 2.41), thyroid stimulating hormone (TSH) 72.04 mU/L (0.35 - 5.5), thyroxine (FT4) 2.2 pmol/L (11,5 -22.7), triiodothyronine (FT3) 0.81 pmol/L (3.5 - 6.5), antibodies against thyroglobuline and peroxidase were positive. On echocardiography intrapericardial 1,8 cm thick effusion was found. Chest X-Rayshowed an enlargement of the heart. The carpal tunnel syndrome of the both hands was shown on EMG. Conclusion: Hypothyroidism is often overlooked because of non specific clinical signs. In our patient outstanding muscular weakness and fatigue were present, as well as other symptoms of hypothyroidism. The diagnosis was confirmed with high concentrations of TSH and low concentrations of FT4 and FT3. Autoimmune mechanism was confirmed by elevated concentrations of antibodies against thyroglobulin and peroxidase and by thyroid ultrasound. Therapy with L-thyroxine was effective. He recovered completely and is now in euthyrotic state.
Descriptors		HYPOTHYROIDISM HEART HYPERTROPHY PERICARDIAL EFFUSION ADULT ECHOCARDIOGRAPHY CARPAL TUNNEL SYNDROME