Hypothyroid myopathy is observed frequently and the resolution of the clinical manifestations of myopathy following thyroid hormone replacement is well known. However, a specific subtype of hypothyroid myopathy, Hoffmann's syndrome, characterized by increased muscular mass (pseudohypertrophy), proximal muscle weakness, muscle stiffness and cramps, is rarely reported. Herein, we describe a 34-year-old male who presented with proximal muscle weakness and non-pitting edema of the lower extremities. He initially visited the neurology department where he was suspected of having polymyositis. Additional laboratory evaluation revealed profound autoimmune hypothyroidism and elevated muscle enzymes including creatine kinase. The patient was started on levothyroxine treatment and, subsequently, clinical symptoms and biochemical parameters resolved with the treatment. The present case highlights that hypothyroidism should be considered in the differential diagnosis of musculoskeletal symptoms even in the absence of overt manifestations of hypothyroidism. To our knowledge, this is the first case reported in Korea.

Citations

Citations to this article as recorded by  

• The association of back pain with physical inactivity and hypothyroidism in pregnant women
  Chencui Shi, Qiangdong Zou, Hong Wei
  Journal of Back and Musculoskeletal Rehabilitation.2024; 37(6): 1663.     CrossRef
• Hoffmann’s syndrome in the differential work-up of myopathic complaints: a case report
  Sabine Winter, Bianka Heiling, Niklas Eckardt, Christof Kloos, Hubertus Axer
  Journal of Medical Case Reports.2023;[Epub]     CrossRef
• Hypothyroidism: A Peculiar Presentation
  Rita V Nogueira, Rui Lima, Carina Parente, Pedro Liberal, Lucia Santos
  Cureus.2023;[Epub]     CrossRef
• Hoffman's syndrome as the presenting manifestation of non-primary hypothyroidism in a case of Prader-Willi Syndrome
  R. Ghosh, A. Ray, D. Roy, J. Benito-Leon
  Neurología.2022; 37(9): 824.     CrossRef
• Hoffman's syndrome as the presenting manifestation of non-primary hypothyroidism in a case of Prader-Willi Syndrome
  R. Ghosh, A. Ray, D. Roy, J. Benito-Leon
  Neurología (English Edition).2022; 37(9): 824.     CrossRef
• Hoffmann’s syndrome necessitating forearm fasciotomy: a case report
  Erling Aarsæther, Ragnar Joakimsen, Hanne Halvorsen, Trude Sildnes, Olav Sivertsen, Jan Due
  Journal of Medical Case Reports.2020;[Epub]     CrossRef
• Hypothyroid myopathy: A peculiar clinical presentation of thyroid failure. Review of the literature
  Alessandro Sindoni, Carmelo Rodolico, Maria Angela Pappalardo, Simona Portaro, Salvatore Benvenga
  Reviews in Endocrine and Metabolic Disorders.2016; 17(4): 499.     CrossRef