Téma:  Case Studies

Rare combination of clinical and laboratory findings in primary hypothyroidism – hoffmann’s syndrome ?

Dušan Trejbal, Dana Šolcová

26 yrs. old patient who was several years followed for elevated serum concentrations of AST, ALT and creatinine was admitted to our internal department for muscle pains and stiffness. Beside elevated AST and ALT laboratory tests showed also markedly elevated values of creatin kinase (CK), higher concentrations of cholesterol, creatinine and mildly increased levels of several tumor-markers. Physical examination showed somatic asthenia, baldness and bradycardia. Markedly elevated concentration of thyrotropine (TSH) and low concentration of free thyroxine confirmed primary hypothyroidism. After thyroid replacement therapy (l-thyroxin 100 µg/day) complete elimination of patient’s complains and normalization of laboratory tests was observed. Mentioned clinical picture (muscle pain, stiffness), elevated CK, AST, ALT and excelent response to replacement therapy may indicate an early stadium of Hoffmann’s syndrome.

Ročník 2007  Témy časopisu Internal medicine 7 / 2007

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