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Case Reports in Pediatrics
Volume 2011 (2011), Article ID 670673, 4 pages
http://dx.doi.org/10.1155/2011/670673
Case Report

Adolescent with Rhabdomyolysis due to Undiagnosed Hypothyroidism

1Department of Pediatrics, Georgetown University Hospital Medical Center, Washington, DC, USA
2Division of Neurology, Georgetown University Hospital Medical Center, Washington, DC, USA
3Division of Endocrinology and Metabolism, Georgetown University Hospital Medical Center, Washington, DC, USA

Received 30 May 2011; Accepted 21 July 2011

Academic Editors: E. N. Ozmert, M. Raes, and K. Sarafidis

Copyright © 2011 Raquel Farias Moeller et al. 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

Exercise-induced rhabdomyolysis has been described in military recruits, trained athletes and daily runners. Statin use, quail ingestion, infection by Epstein-Barr virus (EBV), and hypothyroidism, though rare, are risk factors for the development of rhabdomyolysis. We describe the case of a 15-year-old female who presented with myalgias, weakness, and pigmenturia following marching band practice. Laboratory tests confirmed an elevated creatine kinase (CK) level as well as a profound hypothyroid state. Muscle biopsy revealed severe muscle necrosis and myositis. Treatment with levothyroxine resulted in obtaining an euthyroid state and regain of muscle strength as well as decrease in CK levels. Although rare, hypothyroidism should be considered as a potential cause of rhabdomyolysis in pediatric patients undergoing a myopathy workup.