Untreated primary hypothyroidism with simultaneous rhabdomyolysis, pericardial effusion, and sudden sensorineural hearing loss: A case report

Chung Gyo Seo, Kyoung Jin Kim, Euyhyun Park, Nam Hoon Kim, Joo Hyung Kim, Hee Young Kim, Sin Gon Kim, Kyeong Jin Kim

Research output: Contribution to journalArticle

Abstract

Background: Hypothyroidism, one of the prevalent endocrine disorders worldwide, has a broad spectrum of clinical manifestations, from an asymptomatic condition to myxedema coma. Although the majority of patients with hypothyroidism have minor clinical symptoms, which are recovered with levothyroxine treatment, some patients occasionally do experience fatal complications. Here we report, for the first time, the case of a patient who had hypothyroidism with simultaneous occurrence of rhabdomyolysis with acute kidney injury, moderate pericardial effusion, and sudden sensorineural hearing loss. Case presentation: A 57-year-old man with a previous history of dyslipidemia and untreated hypothyroidism was admitted to the hospital due to shortness of breath, lethargy, lower extremity discomfort, and unilateral hearing loss. Laboratory results revealed rhabdomyolysis with acute kidney injury and severe hypothyroidism. We detected cardiomegaly without lung parenchymal infiltration on chest radiography and moderate pericardial effusion on transthoracic echocardiography. We performed pure tone audiometry and identified profound unilateral sensorineural hearing loss. Aggressive fluid resuscitation, levothyroxine treatment, and systemic and intratympanic steroid therapy alleviated the patient's severe hypothyroidism, rhabdomyolysis, and pericardial effusion; however, sensorineural hearing loss was not fully recovered. Conclusions: Early recognition of life-threatening complications is important in patients with severe hypothyroidism to prevent adverse outcomes. This case suggests that hypothyroidism should be considered in patients who have rhabdomyolysis with acute kidney disease and pericardial effusion. Moreover, sudden sensorineural hearing loss should be kept in mind as a rare complication of hypothyroidism.

Original languageEnglish
Article number52
JournalBMC Endocrine Disorders
Volume19
Issue number1
DOIs
Publication statusPublished - 2019 May 22

Fingerprint

Sudden Hearing Loss
Rhabdomyolysis
Pericardial Effusion
Sensorineural Hearing Loss
Hypothyroidism
Unilateral Hearing Loss
Thyroxine
Acute Kidney Injury
Pure-Tone Audiometry
Myxedema
Asymptomatic Diseases
Lethargy
Kidney Diseases
Cardiomegaly
Acute Disease
Coma
Dyslipidemias
Resuscitation
Radiography
Dyspnea

Keywords

  • Hearing loss
  • Hypothyroidism
  • Pericardial effusion
  • Rhabdomyolysis

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Untreated primary hypothyroidism with simultaneous rhabdomyolysis, pericardial effusion, and sudden sensorineural hearing loss : A case report. / Seo, Chung Gyo; Kim, Kyoung Jin; Park, Euyhyun; Kim, Nam Hoon; Kim, Joo Hyung; Kim, Hee Young; Kim, Sin Gon; Kim, Kyeong Jin.

In: BMC Endocrine Disorders, Vol. 19, No. 1, 52, 22.05.2019.

Research output: Contribution to journalArticle

Seo, Chung Gyo ; Kim, Kyoung Jin ; Park, Euyhyun ; Kim, Nam Hoon ; Kim, Joo Hyung ; Kim, Hee Young ; Kim, Sin Gon ; Kim, Kyeong Jin. / Untreated primary hypothyroidism with simultaneous rhabdomyolysis, pericardial effusion, and sudden sensorineural hearing loss : A case report. In: BMC Endocrine Disorders. 2019 ; Vol. 19, No. 1.
@article{aec6834683504d1c88a843c946f77036,
title = "Untreated primary hypothyroidism with simultaneous rhabdomyolysis, pericardial effusion, and sudden sensorineural hearing loss: A case report",
abstract = "Background: Hypothyroidism, one of the prevalent endocrine disorders worldwide, has a broad spectrum of clinical manifestations, from an asymptomatic condition to myxedema coma. Although the majority of patients with hypothyroidism have minor clinical symptoms, which are recovered with levothyroxine treatment, some patients occasionally do experience fatal complications. Here we report, for the first time, the case of a patient who had hypothyroidism with simultaneous occurrence of rhabdomyolysis with acute kidney injury, moderate pericardial effusion, and sudden sensorineural hearing loss. Case presentation: A 57-year-old man with a previous history of dyslipidemia and untreated hypothyroidism was admitted to the hospital due to shortness of breath, lethargy, lower extremity discomfort, and unilateral hearing loss. Laboratory results revealed rhabdomyolysis with acute kidney injury and severe hypothyroidism. We detected cardiomegaly without lung parenchymal infiltration on chest radiography and moderate pericardial effusion on transthoracic echocardiography. We performed pure tone audiometry and identified profound unilateral sensorineural hearing loss. Aggressive fluid resuscitation, levothyroxine treatment, and systemic and intratympanic steroid therapy alleviated the patient's severe hypothyroidism, rhabdomyolysis, and pericardial effusion; however, sensorineural hearing loss was not fully recovered. Conclusions: Early recognition of life-threatening complications is important in patients with severe hypothyroidism to prevent adverse outcomes. This case suggests that hypothyroidism should be considered in patients who have rhabdomyolysis with acute kidney disease and pericardial effusion. Moreover, sudden sensorineural hearing loss should be kept in mind as a rare complication of hypothyroidism.",
keywords = "Hearing loss, Hypothyroidism, Pericardial effusion, Rhabdomyolysis",
author = "Seo, {Chung Gyo} and Kim, {Kyoung Jin} and Euyhyun Park and Kim, {Nam Hoon} and Kim, {Joo Hyung} and Kim, {Hee Young} and Kim, {Sin Gon} and Kim, {Kyeong Jin}",
year = "2019",
month = "5",
day = "22",
doi = "10.1186/s12902-019-0379-y",
language = "English",
volume = "19",
journal = "BMC Endocrine Disorders",
issn = "1472-6823",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Untreated primary hypothyroidism with simultaneous rhabdomyolysis, pericardial effusion, and sudden sensorineural hearing loss

T2 - A case report

AU - Seo, Chung Gyo

AU - Kim, Kyoung Jin

AU - Park, Euyhyun

AU - Kim, Nam Hoon

AU - Kim, Joo Hyung

AU - Kim, Hee Young

AU - Kim, Sin Gon

AU - Kim, Kyeong Jin

PY - 2019/5/22

Y1 - 2019/5/22

N2 - Background: Hypothyroidism, one of the prevalent endocrine disorders worldwide, has a broad spectrum of clinical manifestations, from an asymptomatic condition to myxedema coma. Although the majority of patients with hypothyroidism have minor clinical symptoms, which are recovered with levothyroxine treatment, some patients occasionally do experience fatal complications. Here we report, for the first time, the case of a patient who had hypothyroidism with simultaneous occurrence of rhabdomyolysis with acute kidney injury, moderate pericardial effusion, and sudden sensorineural hearing loss. Case presentation: A 57-year-old man with a previous history of dyslipidemia and untreated hypothyroidism was admitted to the hospital due to shortness of breath, lethargy, lower extremity discomfort, and unilateral hearing loss. Laboratory results revealed rhabdomyolysis with acute kidney injury and severe hypothyroidism. We detected cardiomegaly without lung parenchymal infiltration on chest radiography and moderate pericardial effusion on transthoracic echocardiography. We performed pure tone audiometry and identified profound unilateral sensorineural hearing loss. Aggressive fluid resuscitation, levothyroxine treatment, and systemic and intratympanic steroid therapy alleviated the patient's severe hypothyroidism, rhabdomyolysis, and pericardial effusion; however, sensorineural hearing loss was not fully recovered. Conclusions: Early recognition of life-threatening complications is important in patients with severe hypothyroidism to prevent adverse outcomes. This case suggests that hypothyroidism should be considered in patients who have rhabdomyolysis with acute kidney disease and pericardial effusion. Moreover, sudden sensorineural hearing loss should be kept in mind as a rare complication of hypothyroidism.

AB - Background: Hypothyroidism, one of the prevalent endocrine disorders worldwide, has a broad spectrum of clinical manifestations, from an asymptomatic condition to myxedema coma. Although the majority of patients with hypothyroidism have minor clinical symptoms, which are recovered with levothyroxine treatment, some patients occasionally do experience fatal complications. Here we report, for the first time, the case of a patient who had hypothyroidism with simultaneous occurrence of rhabdomyolysis with acute kidney injury, moderate pericardial effusion, and sudden sensorineural hearing loss. Case presentation: A 57-year-old man with a previous history of dyslipidemia and untreated hypothyroidism was admitted to the hospital due to shortness of breath, lethargy, lower extremity discomfort, and unilateral hearing loss. Laboratory results revealed rhabdomyolysis with acute kidney injury and severe hypothyroidism. We detected cardiomegaly without lung parenchymal infiltration on chest radiography and moderate pericardial effusion on transthoracic echocardiography. We performed pure tone audiometry and identified profound unilateral sensorineural hearing loss. Aggressive fluid resuscitation, levothyroxine treatment, and systemic and intratympanic steroid therapy alleviated the patient's severe hypothyroidism, rhabdomyolysis, and pericardial effusion; however, sensorineural hearing loss was not fully recovered. Conclusions: Early recognition of life-threatening complications is important in patients with severe hypothyroidism to prevent adverse outcomes. This case suggests that hypothyroidism should be considered in patients who have rhabdomyolysis with acute kidney disease and pericardial effusion. Moreover, sudden sensorineural hearing loss should be kept in mind as a rare complication of hypothyroidism.

KW - Hearing loss

KW - Hypothyroidism

KW - Pericardial effusion

KW - Rhabdomyolysis

UR - http://www.scopus.com/inward/record.url?scp=85066399251&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85066399251&partnerID=8YFLogxK

U2 - 10.1186/s12902-019-0379-y

DO - 10.1186/s12902-019-0379-y

M3 - Article

C2 - 31113413

AN - SCOPUS:85066399251

VL - 19

JO - BMC Endocrine Disorders

JF - BMC Endocrine Disorders

SN - 1472-6823

IS - 1

M1 - 52

ER -