Endocrine Abstracts

Background and aim: Hyperthyroidism status can be complicated by polymorphic neuromuscular manifestations sometimes revealing. In the majority of cases, these disorders regress during the transition to euthyroidism. We report in this work 6 observations illustrating the neuromuscular manifestations seen in hyperthyroidism.

Observations: We report two cases of chronic myopathy: a man and a woman aged 47 and 55 years respectively, hospitalized for hyperthyroidism associated to generalized amyotrophy with functional impotence. The EMG confirmed the muscular damage. Thyrotoxic periodic paralysis was noted in 2 patients, a man and a woman, aged 27 and 34 years respectively. They presented with spontaneously resolving paralytic attacks predominantly in the lower limbs lasting 3 to 24 hours and associated with thyrotoxicosis and hypokalemia. The fifth and sixth patients had peripheral polyneuropathy associated with thyrotoxicosis. They were a 39-year-old woman and a 45-year-old man. The woman presented with parasthesia of the extremities and gait disorders. The man presented with flaccid paraparesis. The electrophysiological study showed neurogenic damage in both cases. Graves’ disease was the cause of hyperthyroidism in 5 cases. Hashimoto’s disease was incriminated in the remaining case.

Discussion: In all of these cases, early treatment led to a dramatic improvement in neuromuscular symptoms. The pathophysiological mechanisms of these disorders remain difficult to elucidate and require more advanced studies on larger cohorts of patients