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Case Reports in Endocrinology
Volume 2014 (2014), Article ID 286450, 3 pages
http://dx.doi.org/10.1155/2014/286450
Case Report

Rhabdomyolysis Induced by Nonstrenuous Exercise in a Patient with Graves’ Disease

1Department of Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, Jamaica, New York, NY 11432, USA
2Division of Endocrinology, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, Jamaica, New York, NY 11432, USA

Received 13 December 2013; Accepted 6 January 2014; Published 11 February 2014

Academic Editors: T. Kita and Y. Moriwaki

Copyright © 2014 Sarawut Summachiwakij and Issac Sachmechi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hyperthyroidism can result in several musculoskeletal conditions such as thyrotoxic periodic paralysis, thyrotoxic myopathy, and thyroid ophthalmopathy. Rhabdomyolysis has been rarely reported to be associated with hyperthyroidism. We describe a 33-year-old man who presented with bilateral thigh pain and dark brown urine after regular squatting. He had a past medical history of hyperthyroidism but stopped taking it 2 months prior to admission. He was found to have rhabdomyolysis, myoglobinuria, and thyrotoxicosis. Presence of thyroid-stimulating immunoglobulins (TSI) and high radioiodine uptake confirmed a diagnosis of Graves' disease. He received aggressive fluid resuscitation and sodium bicarbonate intravenously along with monitoring fluid and electrolyte. Methimazole was also resumed. The patient responded to treatment and rhabdomyolysis gradually resolved. Therefore, nonstrenuous exercise can potentially induce rhabdomyolysis in patients with hyperthyroidism. Although hyperthyroidism is not widely recognized as a cause of rhabdomyolysis, it should be considered in the differential diagnosis of rhabdomyolysis.