{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:53:28Z","timestamp":1787961208779,"version":"build-2784847793"},"reference-count":9,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,7,12]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:p>Muscular symptoms in hypothyroidism are common, including myalgia, fatigue and cramps; however, a significantly raised creatine kinase and muscle weakness are rare. Differential diagnosis of patients presenting with muscle weakness and a raised creatine kinase is wide, and hypothyroidism is rarely considered. We report this case of a 30-year-old female presenting with proximal muscle weakness as her primary symptom, hypothyroid symptoms of 3-month duration and a significantly raised creatine kinase. After ruling out other causes of a raised creatine kinase, thyroxine replacement was commenced, which led to complete resolution of her proximal weakness, myalgia and normalisation of creatine kinase level. This case illustrates severe proximal myopathy can be secondary to hypothyroidism, symptoms can resolve with thyroxine replacement and emphasises the importance of measuring thyroid function in patients with proximal weakness\/myalgia and a significantly raised creatine kinase.<\/jats:p>","DOI":"10.1136\/bcr-2019-230427","type":"journal-article","created":{"date-parts":[[2019,7,27]],"date-time":"2019-07-27T11:46:37Z","timestamp":1564227997000},"page":"e230427","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Severe proximal myopathy secondary to Hashimoto\u2019s thyroiditis"],"prefix":"10.1136","volume":"12","author":[{"given":"William","family":"Jervis","sequence":"first","affiliation":[{"name":"Endocrinology and Diabetes, Hull Royal Infirmary, Hull, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najeeb","family":"Shah","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetes, Hull Royal Infirmary, Hull, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2462-1149","authenticated-orcid":false,"given":"Shiva Kumar","family":"Mongolu","sequence":"additional","affiliation":[{"name":"Michael White Center of Diabetes & Endocrinology, Hull Royal Infirmary, Hull, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thozhukat","family":"Sathyapalan","sequence":"additional","affiliation":[{"name":"Hull York Medical School, University of Hull, Hull, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,7,27]]},"reference":[{"key":"2025082801162234000_12.7.e230427.1","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1007\/s11154-016-9357-0","article-title":"Hypothyroid myopathy: a peculiar clinical presentation of thyroid failure. Review of the literature","volume":"17","author":"Sindoni","year":"2016","journal-title":"Rev Endocr Metab Disord"},{"key":"2025082801162234000_12.7.e230427.2","doi-asserted-by":"crossref","DOI":"10.1002\/mus.10128","article-title":"Hypothyroid myopathy with a strikingly elevated serum creatine kinase level","volume":"26","author":"Scott","year":"2002","journal-title":"Muscle Nerve"},{"key":"2025082801162234000_12.7.e230427.3","first-page":"E614","article-title":"Effect of altered thyroid function on plasma creatine kinase clearance in the dog","volume":"235","author":"Karlsberg","year":"1978","journal-title":"Am J Physiol"},{"key":"2025082801162234000_12.7.e230427.4","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000010318","article-title":"Fenofibrate monotherapy-induced rhabdomyolysis in a patient with hypothyroidism","volume":"97","author":"Wang","year":"2018","journal-title":"Medicine"},{"key":"2025082801162234000_12.7.e230427.5","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000007591","article-title":"Myopathy in hyperthyroidism as a consequence of rapid reduction of thyroid hormone: A case report","volume":"96","author":"Li","year":"2017","journal-title":"Medicine"},{"key":"2025082801162234000_12.7.e230427.6","first-page":"569","article-title":"Myopathy presenting as a sole manifestation of hypothyroidism","volume":"58","author":"Madhu","year":"2010","journal-title":"J Assoc Physicians India"},{"key":"2025082801162234000_12.7.e230427.7","first-page":"559","article-title":"Hypothyroidism simulating as polymyositis","volume":"65","author":"Aslam","year":"2015","journal-title":"J Pak Med Assoc"},{"key":"2025082801162234000_12.7.e230427.8","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1089\/thy.1998.8.1033","article-title":"Myopathy as the persistently isolated symptomatology of primary autoimmune hypothyroidism","volume":"8","author":"Rodolico","year":"1998","journal-title":"Thyroid"},{"key":"2025082801162234000_12.7.e230427.9","unstructured":"Hypothyroidism - NICE CKS [Internet]. 2018 Cks.nice.org.uk (cited 16 Sep 2018)."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-230427","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:16:34Z","timestamp":1756368994000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-230427"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":9,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,7,27]]},"published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1136\/bcr-2019-230427"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-230427","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7]]}}}