{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T14:04:35Z","timestamp":1772892275587,"version":"3.50.1"},"reference-count":15,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,1,16]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Hoffmann syndrome, a rare manifestation of hypothyroid myopathy in adults, is characterised by muscle weakness, stiffness and pseudohypertrophy. Here, we report the case of a middle-aged man who presented with progressive weakness in proximal muscles (in the form of difficulty in climbing stairs, rising from a seated position, combing hair and lifting objects) and leg swelling for 6\u2009months. Physical examination revealed pseudohypertrophy of calf muscles with pronounced symmetric weakness in proximal upper and lower limbs. His levels of thyroid stimulating hormone and creatine kinase were significantly elevated. Electromyography was indicative of a myopathic disorder. MRI revealed symmetrical hyperintensity of bilateral gastrocnemius\u2013soleus muscles. Following the initiation of thyroxine therapy, there was a marked improvement in signs and symptoms. Hypothyroidism should be considered as a potential cause in the differential diagnosis of individuals presenting with muscle weakness and hypertrophy.<\/jats:p>","DOI":"10.1136\/bcr-2024-262110","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T11:55:53Z","timestamp":1738065353000},"page":"e262110","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Muscle pseudohypertrophy as the presenting manifestation of autoimmune hypothyroidism: Hoffmann\u2019s syndrome"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3809-8926","authenticated-orcid":false,"given":"Atanu","family":"Chandra","sequence":"first","affiliation":[{"name":"Internal Medicine, Bankura Sammilani Medical College, Bankura, West Bengal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moni Sankar","family":"Bhattacharjee","sequence":"additional","affiliation":[{"name":"Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Purbasha","family":"Biswas","sequence":"additional","affiliation":[{"name":"Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parthasarathi","family":"Karmakar","sequence":"additional","affiliation":[{"name":"Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,28]]},"reference":[{"key":"2025082723463413000_18.1.e262110.1","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s12325-019-01080-8","article-title":"Hypothyroidism in Context: Where We\u2019ve Been and Where We\u2019re Going","volume":"36","author":"Chiovato","year":"2019","journal-title":"Adv Ther"},{"key":"2025082723463413000_18.1.e262110.2","doi-asserted-by":"crossref","first-page":"506","DOI":"10.4183\/aeb.2017.506","article-title":"MUSCULAR HYPERTROPHY AS ATYPICAL INITIAL PRESENTATION OF HYPOTHYROIDISM","volume":"13","author":"Ayd\u0131n","year":"2017","journal-title":"Acta Endocrinol (Buchar)"},{"key":"2025082723463413000_18.1.e262110.3","first-page":"130","article-title":"Endocrine myopathies: clinical and histopathological features of the major forms","volume":"39","author":"Rodolico","year":"2020","journal-title":"Acta Myol"},{"key":"2025082723463413000_18.1.e262110.4","doi-asserted-by":"crossref","DOI":"10.1186\/1755-7682-7-2","article-title":"Hoffmann syndrome: a case report","volume":"7","author":"Senanayake","year":"2014","journal-title":"Int Arch Med"},{"key":"2025082723463413000_18.1.e262110.5","doi-asserted-by":"crossref","first-page":"626","DOI":"10.3803\/EnM.2015.30.4.626","article-title":"A Rare Manifestation of Hypothyroid Myopathy: Hoffmann\u2019s Syndrome","volume":"30","author":"Lee","year":"2015","journal-title":"Endocrinol Metab (Seoul)"},{"key":"2025082723463413000_18.1.e262110.6","first-page":"OL01","article-title":"Hoffmann\u2019s Syndrome- A Rare Form of Hypothyroid Myopathy","volume":"11","author":"Achappa","year":"2017","journal-title":"J Clin Diagn Res"},{"key":"2025082723463413000_18.1.e262110.7","doi-asserted-by":"crossref","first-page":"307","DOI":"10.5114\/reum.2018.79502","article-title":"Differential diagnosis of idiopathic inflammatory myopathies in adults - the first step when approaching a patient with muscle weakness","volume":"56","author":"Szcz\u0119sny","year":"2018","journal-title":"Reumatologia"},{"key":"2025082723463413000_18.1.e262110.8","doi-asserted-by":"publisher","DOI":"10.1089\/10507250252949478"},{"key":"2025082723463413000_18.1.e262110.9","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1093\/qjmed\/hcac231","article-title":"Hoffman myopathy and hypothyroidism","volume":"116","author":"Datta","year":"2023","journal-title":"QJM"},{"key":"2025082723463413000_18.1.e262110.10","doi-asserted-by":"crossref","first-page":"447","DOI":"10.4103\/0976-3147.140025","article-title":"Hoffman\u2019s syndrome - A rare facet of hypothyroid myopathy","volume":"5","author":"Mangaraj","year":"2014","journal-title":"J Neurosci Rural Pract"},{"key":"2025082723463413000_18.1.e262110.11","doi-asserted-by":"publisher","DOI":"10.1007\/s11154-016-9357-0"},{"key":"2025082723463413000_18.1.e262110.12","first-page":"332","article-title":"Hoffmann syndrome: presentation in hypothyroidism","volume":"51","author":"Udayakumar","year":"2005","journal-title":"J Postgrad Med"},{"key":"2025082723463413000_18.1.e262110.13","first-page":"15906840","article-title":"Hoffmann syndrome","volume":"52","author":"Aleem","year":"2004","journal-title":"J Assoc Physicians India"},{"key":"2025082723463413000_18.1.e262110.14","article-title":"A Complex Case of Polymyositis Overlapping With Hypothyroid Myopathy Without Underlying Autoimmune Thyroid Disorder","volume":"12","author":"Garg","year":"2020","journal-title":"Cureus"},{"key":"2025082723463413000_18.1.e262110.15","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1007\/s00256-015-2226-1","article-title":"Hoffmann\u2019s disease: MR imaging of hypothyroid myopathy","volume":"44","author":"Chung","year":"2015","journal-title":"Skeletal Radiol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-262110","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:46:43Z","timestamp":1756363603000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-262110"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,28]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bcr-2024-262110"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-262110","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}