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Polymyositis after propylthiouracil treatment for hyperthyroidism.

W J Shergy1, D S Caldwell

  • 1Duke University Medical Center, Durham, North Carolina 27710.

Annals of the Rheumatic Diseases
|April 1, 1988
PubMed
Summary
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Thyroid disease can cause muscle problems. A rare case shows polymyositis, an inflammatory muscle disease, developing after treating hyperthyroidism with propylthiouracil.

Area of Science:

  • Endocrinology
  • Neurology
  • Rheumatology

Background:

  • Thyroid dysfunction, both hypothyroidism and hyperthyroidism, is linked to diverse muscle abnormalities, including myalgias and myopathy.
  • Polymyositis, an inflammatory muscle disease, has not been previously documented as an immediate complication following treatment for active hyperthyroidism.

Observation:

  • A patient with overt hyperthyroidism presented with significant proximal muscle weakness and elevated creatine phosphokinase levels.
  • These symptoms emerged shortly after initiating treatment with propylthiouracil (100 mg orally, three times daily) for hyperthyroidism.

Findings:

  • Diagnostic evaluations including electromyography and muscle biopsy, alongside the clinical progression, were indicative of polymyositis.
  • The observed muscle weakness and elevated creatine phosphokinase were consistent with this diagnosis.

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Implications:

  • This case highlights the potential for polymyositis to occur in the context of thyroid disease, specifically after hyperthyroid treatment.
  • Physicians should maintain awareness of the spectrum of muscle disorders associated with thyroid conditions, including thionamide drug reactions and polymyositis.
  • Further investigation is needed to determine if this association is causal or coincidental.