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Related Experiment Videos

Critical illness myopathy associated with hyperthyroidism.

Jack E Riggs1, Hemant K Pandey, Sydney S Schochet

  • 1Department of Neurology, West Virginia University School of Medicine, Morgantown, WV, USA.

Military Medicine
|February 18, 2004
PubMed
Summary

Hyperthyroidism may increase the risk of critical illness myopathy in intensive care unit patients receiving common treatments. Promptly treating hyperthyroidism can rapidly improve severe weakness.

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Area of Science:

  • Critical care medicine
  • Endocrinology
  • Neuromuscular disorders

Background:

  • Critical illness myopathy (CIM) is a common complication in intensive care units (ICUs).
  • CIM is often associated with prolonged mechanical ventilation and poor outcomes.
  • Risk factors for CIM include sepsis, inflammation, and certain medications.

Observation:

  • A 51-year-old woman with chronic obstructive pulmonary disease exacerbation developed severe weakness in the ICU.
  • Her serum creatine kinase was elevated, and muscle biopsy confirmed critical illness myopathy.
  • Resting tachycardia led to the diagnosis of previously unrecognized hyperthyroidism.

Findings:

  • The patient's hyperthyroidism was treated with iodine-131 and methimazole.
  • Her critical illness myopathy-related weakness significantly improved within one month of hyperthyroidism treatment.

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  • Metabolic alterations in hyperthyroidism may predispose patients to CIM when treated with antibiotics, neuromuscular blockers, and steroids.

    • Implications:

    • Hyperthyroidism should be considered in the differential diagnosis of unexplained weakness in ICU patients.
    • Early diagnosis and treatment of hyperthyroidism may prevent or mitigate critical illness myopathy.
    • This case highlights the complex interplay between endocrine disorders and critical illness complications.