Hypothyroidism can cause a myopathy. In some patients there may be a rhabdomyolysis. The occurrence of rhabdomyolysis may be the first sign of an underlying hypothyroidism.
Clinical features:
(1) hypothyroidism
(2) rhabdomyolysis
(3) exclusion of other causes
(4) improvement with optimum therapy of the hypothyroidism
The patient may show other features of hypothyroidism:
(1) psychosis or other psychiatric findings
(2) pericardial effusion
The rhabdomyolysis can be recurrent, especially if the hypothyroidism is poorly controlled.
Severe rhabdomyolysis can result in acute renal failure.
Rhabdomyolysis associated with hypothyroidism has occurred in patients treated with statins or other drugs. Causation can be difficult to prove in these cases, or the occurrence of synergy in effects.
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