Severe Hypothyroidism Presenting as Rhabdomyolysis and Acute Kidney Injury: A Report of a Rare Case.
Level 4 - case-series / case-control
Single clinical case report
PubMed 42549371 · doi:10.7759/cureus.112029
What was done
A case report describing the clinical presentation, diagnostic workup (including laboratory testing, thyroid ultrasound, echocardiography, and kidney biopsy), and management of a 44-year-old man who presented with acute kidney injury and severe rhabdomyolysis secondary to profound autoimmune hypothyroidism.
What was found
Initial testing demonstrated stage II acute kidney injury, severe rhabdomyolysis with creatine phosphokinase levels >8,450 IU/L (reference range: <171 IU/L), liver cytolysis, markedly elevated thyroid-stimulating hormone, very low free thyroxine, and positive anti-thyroid peroxidase antibodies. Renal biopsy showed tubulointerstitial injury with pigmented casts, tubular atrophy, and focal segmental glomerulosclerosis with nephrotic-range proteinuria. Echocardiography showed moderate pericardial effusion. Intravenous hydration and gradual levothyroxine replacement led to clinical improvement and progressive normalization of laboratory abnormalities.
Why it matters
This report underscores severe hypothyroidism as a rare and potentially overlooked cause of rhabdomyolysis and acute renal failure, where prompt recognition and hormone replacement therapy can reverse severe multi-organ abnormalities.
Limits
This is a descriptive single-patient case report (n = 1) without a control group. Exact numerical values for thyroid hormones, serum creatinine, and proteinuria before and after treatment were not reported in the abstract.
Cited by
- supports Thinning or loss of the lateral third of the eyebrow is a classic sign of thyroid dysfunction.