Refractory Acute Kidney Injury Secondary to Hypothyroid-Induced Myopathy: A Contemporary Case Report

Phillip Ulyanovskiy, Deborah Dergan, Shams Abbas, Prabhjot Manes, Irina Erlikh

Abstract


This is a case report elucidating how severe hypothyroid-induced myopathy can lead to refractory kidney injury, unmanageable by standard medical and hemodialysis interventions. A 70-year-old female with extensive medical comorbidities including adult onset hypothyroidism, hypertension, hyperlipidemia, and normal baseline renal function presented with shortness of breath, myalgias, edema, and facial swelling. The patient was found to have a thyroid-stimulating hormone of 169.8 uIU/mL, creatine phosphokinase of 42,670 U/L, blood urea nitrogen of 70 mg/dL, a creatinine of 12.1 mg/dL, and glomerular filtration rate of 3 mL/min/1.73 m2. She was initiated on aggressive intravenous isotonic rehydration, along with intensive intravenous thyroid hormone replacement therapy and hydrocortisone treatment as well. Her renal status failed to improve adequately and she was started on sodium bicarbonate for urinary alkalinization. With the preceding interventions deemed medically futile for renal amelioration, the patient was started on acute hemodialysis. Over the course of 2 weeks and six hemodialysis treatments, the patients renal status failed to improve. The patient finally refused any further hemodialysis or medical interventions seeing that her kidneys failed to respond to treatment, and her clinical prognosis remained poor. This case report illustrates how severe symptomatic hypothyroidism can induce rhabdomyolysis leading to intractable kidney failure, unmanageable by standard medical therapy and hemodialysis.





J Med Cases. 2017;8(1):8-10
doi: https://doi.org/10.14740/jmc2699w


Keywords


Hypothyroidism; Hypothyroid-induced myopathy; Rhabdomyolysis; Acute kidney injury; Acute renal failure; Acute hemodialysis; Thyroid hormone; Thyroid hormone replacement therapy

Full Text: HTML PDF
 

Browse  Journals  

 

Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

 

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

 

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

 

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

 

Journal of Neurology Research

International Journal of Clinical Pediatrics

 

 
       
 

Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)


This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.journalmc.org   editorial contact: editor@journalmc.org    elmer.editorial@hotmail.com
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.


Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.