Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia
Vol 72 No 5 (2022): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo

Rhabdomyolysis in Thyroid Crisis

Nanny Natalia Mulyani Soetedjo (Divisi Endokrinologi, Metabolik dan Diabetes, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Padjadjaran – RSUP Dr. Hasan Sadikin Bandung, Indonesia)
Luse Loe (Departemen Penyakit Dalam, Fakultas Kedokteran dan Ilmu Kesehatan Atma Jaya, Universitas Katolik Indonesia Atma Jaya, Jakarta)
Maya Kusumawati (Divisi Endokrinologi, Metabolik dan Diabetes, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Padjadjaran – RSUP Dr. Hasan Sadikin Bandung, Indonesia)
Ervita Ritonga (Divisi Endokrinologi, Metabolik dan Diabetes, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Padjadjaran – RSUP Dr. Hasan Sadikin Bandung, Indonesia)
Hikmat Permana (Divisi Endokrinologi, Metabolik dan Diabetes, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Padjadjaran – RSUP Dr. Hasan Sadikin Bandung, Indonesia)



Article Info

Publish Date
21 Nov 2022

Abstract

Introduction: Hyperthyroidism might lead to rhabdomyolysis. Rhabdomyolysis in thyroid crisis is very rare, currently there are only 7 cases in the world. This is the eight cases in the world that had been reported.Cases: We reported a case of a 46-year-old man with Graves’ Disease who presented with thyroid crisis and rhabdomyolysis.Discussion: The patient came with shortness of breath and palpitations for 10 hours before admission. Tachycardia, tachypnea, thyroid enlargement, motoric weakness, and bilateral lung crackles were noted. The Burch-Wartofsky Point Scale was 60 and the Japan Thyroid Association grade was TS2 first combination. Laboratory showed hyperkalemia (7.7 meq/L), increase in urea (144 mg/dl), creatinine (1.92 mg/dl), fT4 ( greater than 5.0), TSHs (0.06 uIU/ml) creatine kinase (3645 U/L), positive TRAb and Anti-TPO. The patient was treated with thyroid crisis management (propylthiouracil, lugol, dexamethasone) and supportive treatment (dobutamine, digoxin, furosemide, antibiotics, hyperkalemia therapy). After hospitalized for 11 days, the patient was discharged with resolution clinical symptom and levels of CK, urea, and creatinine. Conclusion: Hyperthyroidism might lead to rhabdomyolysis. This condition needs to be recognized and becomes a differential diagnosis in non-traumatic rhabdomyolysis accompanied by acute kidney injury. Therefore, can lead to appropriate and prompt management.

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Journal Info

Abbrev

jurnal

Publisher

Subject

Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

Description

Journal Of The Indonesian Medical Association (JInMA) / Majalah Kedokteran Indonesia (MKI) adalah Jurnal yang berada di bawah naungan Pengurus Besar Ikatan Dokter Indonesia (PB IDI) dan sebagai Kanal InformasiIlmiah di Kalangan Dokter Umum dan Dokter Spesialis serta Profesi ...