A Case of Hypothyroid Myopathy Found in Periodic Health Examination.

Cho, Young Gyu; Song, Hye Ryoung; Kang, Jae Heon

Case Report

Journal of the Korean Academy of Family Medicine 2008;29(8):612-616.
Published online August 10, 2008.

A Case of Hypothyroid Myopathy Found in Periodic Health Examination.

Young Gyu Cho, Hye Ryoung Song, Jae Heon Kang

Department of Family Medicine, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea. fmleader@nuri.net

건강검진에서 발견된 갑상선기능저하증성 근육병증 1예

조영규,송혜령,강재헌

인제대학교 의과대학 서울백병원 가정의학교실

Abstract

Myalgia, muscle weakness, muscle cramping, muscular rigidity and elevated levels of serum creatinine kinase (CK) are very common in patients with hypothyroidism. However, these symptoms are not clinically serious in most cases and are not found in primary care. So far, 5 Cases with hypothyroid myopathy have been reported in the Korean literature. However, it is not reported that this case has been found in primary care or in periodic health examination. We report a case of hypothyroid myopathy that was presented with exercise-induced myalgia. This case was diagnosed as hypothyroid myopathy through abnormal thyroid function test and elevated levels of serum CK and myoglobin in periodic health examination. Muscle symptoms and laboratory abnormality were improved only with thyroid hormone replacement therapy. (J Korean Acad Fam Med 2008;29:612-616)

Key Words: hypothyroidism, myopathy, rhabdomyolysis, myxedema, creatine kinase

초록

갑상선기능저하증 환자에서 근육통, 근무력감, 근경련, 근경직과 같은 근육 증상과 creatine kinase (CK)와 같은 근육효소의 상승은 매우 흔하게 동반되는 현상이나, 대부분은 임상적으로 문제가 될 정도로 정도가 심하지 않아서, 일차의료 외래에서 갑상선기능저하증성 근육병증으로 진단되는 경우는 흔하지 않다. 지금까지 국내에서는 총 5례가 보고되었으나, 일차의료 외래나 건강검진 시에 발견된 사례에 대한 보고는 없었다. 저자들은 1달 전부터 시작된 보행 시 하지 불편감으로 인해 건강검진을 받은 환자에서 갑상선기능검사, 혈청 CK, myoglobin을 비롯한 혈액검사를 통해 갑상선기능저하증성 근육병증을 진단하였고, 갑상선호르몬 보충요법만으로 증상 및 검사 소견이 호전을 보인 1예를 경험하였기에 문헌고찰과 함께 증례를 보고하는 바이다.

중심 단어: 갑상선기능저하증, 근육병증, 횡문근융해증, 점액부종, Creatine kinase