{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T10:59:07Z","timestamp":1766487547257,"version":"3.48.0"},"reference-count":6,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,10]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Pseudohypertrophy of muscles is a rare and under-recognised form of hypothyroid myopathy primarily affecting the calf muscles, in association with elevated muscle enzymes. We report the case of an adult male in his late 20s presenting with progressive bilateral calf swelling, muscle stiffness and difficulty rising from a squatting position. Despite the absence of classical hypothyroid symptoms, clinical evaluation revealed delayed reflexes and ichthyotic skin. Biochemical studies confirmed severe hypothyroidism with markedly elevated creatine phosphokinase and lactate dehydrogenase levels. MRI findings were consistent with pseudohypertrophy and muscle oedema. Initiation of levothyroxine therapy (100 \u03bcg daily) led to significant clinical and biochemical improvement over 8 weeks, including reduction in calf girth and normalisation of enzyme levels. This case underscores the importance of recognising pseudohypertrophy of muscles secondary to hypothyroidism in patients with unexplained muscle hypertrophy, as prompt thyroid hormone replacement can reverse both symptoms and underlying pathology.<\/jats:p>","DOI":"10.1136\/bcr-2025-268376","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T10:55:20Z","timestamp":1766487320000},"page":"e268376","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["A rare presentation of hypothyroid myopathy: pseudohypertrophy of calf muscles"],"prefix":"10.1136","volume":"18","author":[{"given":"Aditya","family":"Chaudhry","sequence":"first","affiliation":[{"name":"General Medicine, Santosh University, Ghaziabad, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9314-9490","authenticated-orcid":false,"given":"Ashok","family":"Kumar","sequence":"additional","affiliation":[{"name":"General Medicine, Santosh University, Ghaziabad, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prasanth","family":"Gutti","sequence":"additional","affiliation":[{"name":"General Medicine, Santosh University, Ghaziabad, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"2025122302550920000_18.12.e268376.1","first-page":"278","article-title":"Weiteger beitrag zur lehr von tetanie","volume":"9","author":"Hoffman","year":"1897","journal-title":"Deutsch Z Nervenheilk"},{"key":"2025122302550920000_18.12.e268376.2","first-page":"153143","article-title":"Kocher-debre-semelaigne syndrome: hypothyroid muscular pseudohypertrophy-a rare report of two cases","volume":"2012","author":"Shaw","year":"2012","journal-title":"Case Rep Endocrinol"},{"key":"2025122302550920000_18.12.e268376.3","doi-asserted-by":"crossref","first-page":"42","DOI":"10.4103\/trp.trp_33_18","article-title":"Hoffmann syndrome: A rare and reversible case of hypothyroid myopathy","volume":"16","author":"Sharma","year":"2019","journal-title":"Thyroid Res Pract"},{"key":"2025122302550920000_18.12.e268376.4","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.49.621"},{"key":"2025122302550920000_18.12.e268376.5","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":"2025122302550920000_18.12.e268376.6","doi-asserted-by":"crossref","DOI":"10.1186\/s13256-023-04184-6","article-title":"Hoffmann\u2019s syndrome in the differential work-up of myopathic complaints: a case report","volume":"17","author":"Winter","year":"2023","journal-title":"J Med Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268376","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T10:55:21Z","timestamp":1766487321000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268376"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":6,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,23]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2025-268376"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268376","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}