title: Rhabdomyolysis, renal failure, pericardial effusion, and acquired von Willebrand disease resulting from hypothyroidism in a 10-year-old girl.
abstract: A 10-year-old girl manifested unexplained muscle aches and high creatine phosphokinase (CPK) concentrations attributed to rhabdomyolysis in association with severe hypothyroidism due to autoimmune thyroiditis. The response to therapy strongly suggested that hypothyroidism was the cause of rhabdomyolysis. Hypothyroidism is a rare cause of rhabdomyolysis. It should always be considered in a patient with muscular symptoms and elevated CPK concentrations. In addition, the patient developed other uncommon manifestations of hypothyroidism such as pericardial effusion, acute renal failure, and acquired von Willebrand disease. After thyroxine replacement, the symptoms and abnormal findings disappeared. The patient was also diagnosed as having celiac disease, which is often associated with autoimmune thyroiditis. Conditions accompanying autoimmune thyroid disease may result from altered thyroid function and from the presence of other autoimmune diseases. The butterfly-shaped thyroid gland has a tremendous impact on metabolism, which may be compared to a phenomenon termed the "Butterfly Effect".
authors.affiliation: 4th Department of Paediatrics, Medical School, Aristotle University of Thessaloniki, Greece. galtsin@otenet.gr
authors.forename: Assimina
authors.initials: A
authors.lastname: Galli-Tsinopoulou
authors.forename: Charilaos
authors.initials: C
authors.lastname: Stylianou
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Kokka
authors.forename: Kokka
authors.initials: K
authors.lastname: Paraskevi
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Panagopoulou
authors.forename: Panagopoulou
authors.initials: P
authors.lastname: Paraskevi
authors.forename: Sanda
authors.initials: S
authors.lastname: Nousia-Arvanitakis
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D002446:Celiac Disease / Q000150:complications; D002648:Child; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications*; D010490:Pericardial Effusion / Q000209:etiology*; D012206:Rhabdomyolysis / Q000097:blood / Q000209:etiology*; D014842:von Willebrand Diseases / Q000209:etiology*
chemical_list: D003402:Creatine Kinase