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KMID : 0374920140350010145
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Inje Medical Journal
2014 Volume.35 No. 1 p.145 ~ p.151
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Rhabdomyolysis Caused by the Hypothyroidism in a Patient with Acute Cerebral Infarction
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Seo Young-Ki
Koo Ho-Seok
Mo Jin-Won
Sung Hyun
Doh Young-Seok
Kim Mi-Ryeong
Kim Ji-Young
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Abstract
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The causes of rhabdomyolysis include severe infections, trauma, metabolic disorders, drugs, and electrolyte abnormalities, as well as hypothyroidism in rare cases. Moreover, rhabdomyolysis by acute ischemic stroke is not rare. A 56-year-old man was admitted to the emergency room, presenting with right side weakness, dysarthria and general weakness that occurred after sleep. He denied any previous medical and drug medication history. We found a newly developed acute infarction at the parietopontine tract near the left thalamus on the brain MRI, and the levels of creatine kinase(CK), transaminases, myoglobin and lactate dehydrogenase(LDH) were elevated. To investigate the cause of the rhabdomyolysis, a CK electrophoresis was performed, and the electrophoresis pattern of the serum CK isoenzyme showed the MM fraction only(100%). In addition, tests were performed to discriminate the cause of rhabdomyolysis, and we determined that the patient had severe hypothyroidism. Therefore, we treated him with antiplatelet therapy for acute ischemic stroke and levothyroxine therapy for hypothyroidism. After these treatments, the CK level decreased, and the right hemiplegia and dysarthria symptoms improved. We suggest that the hypothyroidism caused the rhabdomyolysis via an acute kidney injury. The treatment with levothyroxine improved the rhabdomyolysis and acute kidney injury.
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KEYWORD
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Cerebral infarction, Rhabdomyolysis, Hypothyroidism, Levothyroxine, Acute kidney injury
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