{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T21:59:09Z","timestamp":1776722349686,"version":"3.51.2"},"reference-count":7,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100019779","name":"Qatar National Library","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019779","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medical Case Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>This case describes a 28-year-old female with amyotrophic lateral sclerosis and recurrent urinary tract infections who developed myxedema coma following a botulinum toxin type-A (Btx) injection for muscle spasticity. On intensive care unit admission, she presented with hypothermia, bradycardia, and reduced consciousness. Laboratory evaluation revealed markedly elevated thyroid-stimulating hormone levels, confirming myxedema coma. Prompt treatment with intravenous levothyroxine and hydrocortisone resulted in rapid improvement in temperature and mental status. Further investigation showed elevated antithyroid peroxidase antibodies, suggesting drug-induced autoimmune thyroiditis triggered by Btx. This case highlights the potential link between Btx injection and thyroid autoimmunity, emphasizing the importance of early recognition and monitoring of thyroid function to prevent life-threatening complications in at-risk patients.<\/jats:p>","DOI":"10.1177\/2050313x261430649","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T10:39:30Z","timestamp":1774953570000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Botulinum toxin injection induced autoimmune thyroiditis and myxedema coma: A case report"],"prefix":"10.1177","volume":"14","author":[{"given":"Khaled","family":"Gazwi","sequence":"first","affiliation":[{"name":"Critical Care Department, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tareq","family":"Zaza","sequence":"additional","affiliation":[{"name":"Critical Care Department, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5309-8641","authenticated-orcid":false,"given":"Hassan","family":"Mitwally","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikeshkumar","family":"Davda","sequence":"additional","affiliation":[{"name":"Critical Care Department, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adel","family":"Ganaw","sequence":"additional","affiliation":[{"name":"Anesthesia and Critical Care Department, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3310\/hta14260"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","DOI":"10.1097\/00002508-200211001-00011","article-title":"Treatment of spasticity with botulinum toxin","volume":"18","author":"O\u2019Brien CF.","year":"2002","unstructured":"O\u2019Brien CF. Treatment of spasticity with botulinum toxin. 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