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Related Experiment Videos

Hypothyroidism presenting with respiratory muscle weakness.

C M Laroche1, T Cairns, J Moxham

  • 1Respiratory Muscle Laboratory, Brompton Hospital, London, England.

The American Review of Respiratory Disease
|August 1, 1988
PubMed
Summary

Severe hypothyroidism can cause significant respiratory muscle weakness and phrenic nerve damage, leading to breathlessness. Fortunately, these symptoms are reversible with thyroid hormone replacement therapy.

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Area of Science:

  • Pulmonary Medicine
  • Endocrinology
  • Neurology

Background:

  • Hypothyroidism is a common endocrine disorder that can affect multiple organ systems.
  • Respiratory symptoms are not typically considered a primary manifestation of hypothyroidism.

Observation:

  • A 58-year-old woman presented with recurrent chest infections, dyspnea, and orthopnea, alongside symptoms of severe hypothyroidism.
  • Investigations revealed elevated diaphragm, global respiratory muscle weakness, and severe bilateral diaphragm weakness with impaired phrenic nerve function.
  • Phrenic nerve conduction times were prolonged, and diaphragm relaxation rates were abnormally slow.

Findings:

  • Thyroid function tests confirmed severe hypothyroidism (TSH > 50 mU/L, T4 = 23 nmol/L).
  • Maximal respiratory pressures and transdiaphragmatic pressures indicated significant respiratory muscle weakness.

Related Experiment Videos

  • Phrenic nerve stimulation studies demonstrated absent or reduced diaphragmatic response and prolonged nerve conduction times.

    • Implications:

    • This case highlights that severe hypothyroidism can manifest as breathlessness due to reversible respiratory muscle and phrenic nerve dysfunction.
    • Prompt diagnosis and treatment with thyroxine can normalize respiratory parameters and alleviate symptoms.
    • Clinicians should consider hypothyroidism in the differential diagnosis of unexplained respiratory muscle weakness and neuropathy.