title: Abrupt onset of muscle dysfunction after treatment for Grave's disease: a case report.
abstract: Myopathy is a known complication of hypothyroidism, commonly characterized by an elevation in Creatine Kinase (CPK) due to increase capillary permeability proportional to the hypothyroid state. Thyroid hormone is important for the expression of fast myofibrillar proteins in the muscle. In hypothyroidism the expression of these proteins are deficient and there is an increase accumulation of slow myofibrillar proteins. A rapid or abrupt descend in thyroid hormones caused by radioiodine therapy after prolonged hyperthyroidism can lead to local hypothyroid state within the muscle tissue, resulting in CPK elevation and hypothyroid myopathy. Hormone replacement leads to resolution of symptoms and normalization of muscle enzymes serum levels.
authors.forename: José
authors.initials: J
authors.lastname: Hernán Martínez
authors.forename: Alfredo
authors.initials: A
authors.lastname: Sánchez
authors.forename: Oberto
authors.initials: O
authors.lastname: Torres
authors.forename: Coromoto
authors.initials: C
authors.lastname: Palermo
authors.forename: Mónica
authors.initials: M
authors.lastname: Santiago
authors.forename: Carlos
authors.initials: C
authors.lastname: Figueroa
authors.forename: Rafael
authors.initials: R
authors.lastname: Trinidad
authors.forename: Michelle
authors.initials: M
authors.lastname: Mangual
authors.forename: Madeleine
authors.initials: M
authors.lastname: Gutierrez
authors.forename: Eva
authors.initials: E
authors.lastname: González
authors.forename: María de Lourdes
authors.initials: Mde L
authors.lastname: Miranda
mesh_terms: D003937:Diagnosis, Differential; D004487:Edema / Q000209:etiology; D004576:Electromyography; D004630:Emergencies; D005260:Female; D006111:Graves Disease / Q000532:radiotherapy*; D020249:Hormone Replacement Therapy; D006801:Humans; D006980:Hyperthyroidism / Q000175:diagnosis; D007037:Hypothyroidism / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D007457:Iodine Radioisotopes / Q000009:adverse effects* / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008713:Methimazole / Q000627:therapeutic use; D009120:Muscle Cramp / Q000209:etiology*; D018908:Muscle Weakness / Q000209:etiology*; D011433:Propranolol / Q000627:therapeutic use; D012021:Reflex, Abnormal; D013963:Thyroid Hormones / Q000097:blood / Q000502:physiology; D013974:Thyroxine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes; D013963:Thyroid Hormones; D008713:Methimazole; D011433:Propranolol; D013974:Thyroxine