HASHIMOTO'S THYROIDITIS ASSOCIATED WITH RHABDOMYOLYSIS AFTER INFECTION WITH COVID19

Date

2023

Authors

Park, Daniel
Mebane, Nova
Mebane, Neva
Salloum, Cynthia

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Abstract

This case study discusses the care of a 74-year-old female with three hospital admissions over the year 2022. There will be a detailed focus on the second admission. Her chief complaint for her second admission was generalized weakness and fatigue with an initial creatinine kinase of greater than 50,000 Units/L (reference range 25-192) and a thyroid stimulating hormone level of 178. She was initially treated with intravenous fluids, IV levothyroxine, and IV hydrocortisone. During the middle of her second hospitalization, intravenous immunoglobulin was added to her treatment regimen. The patient was discharged from her second hospitalization and readmitted one day later due to severe blood loss secondary to a muscle biopsy hematoma. The patient was discharged with baseline ambulation and mentation after receiving multiple blood transfusions in addition to the continuation of oral levothyroxine and oral steroids.

Conclusions: This case study represents another contribution to scientific literature towards the suggestion that Hashimoto’s Thyroiditis is associated with severe rhabdomyolysis. In addition, this case study suggests a possible association between people developing autoimmune thyroiditis and rhabdomyolysis post-infection with COVID-19. In patients with rhabdomyolysis, physicians should consider ordering a TSH with close outpatient follow-up. Investigation into the use of intravenous immunoglobulin for severe Hashimoto’s Thyroiditis may prove beneficial for patients.

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