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  • Title: [Hypothyroidism with leading myopathy in a patient suffering from systemic lupus erythematosus and Hashimoto's thyroiditis].
    Author: Judex A, Hartung W, Schölmerich J, Fleck M.
    Journal: Med Klin (Munich); 2008 Oct 15; 103(10):731-5. PubMed ID: 18936898.
    Abstract:
    BACKGROUND: Muscle weakness with or without elevation of serum creatine kinase (CK) is a common complaint, which is a diagnostic challenge for the treating physician. Either infectious, neurologic, iatrogenic, genetic or endocrinologic and rheumatologic causes should be considered. CASE REPORT: A 66-year-old female patient with a history of systemic lupus erythematosus (SLE) currently in remission presented herself with muscle weakness, myalgias and elevated CK (1618 U/l) to the authors' hospital. A flare of the SLE as cause of the symptoms could be ruled out diagnostically. Instead, a Hashimoto's-associated hypothyroidism was detected. Treatment with L-thyroxine resulted in rapid improvement of symptoms, and CK levels returned to normal. CONCLUSION: Although a myositis can be observed in SLE patients suffering from muscle weakness with elevated CK levels, a careful evaluation is warranted. In the presented case, hypothyroidism due to Hashimoto's thyroiditis was the real culprit of the symptoms.
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