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Revista Médica Sinergia

2022, Number 07

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Revista Médica Sinergia 2022; 7 (07)

Peripheral mixta lumbar neuropathy as manifestation of hypothyroidism: case report

Soto CGM, Masis MA, Madrigal CJP, Ramírez ZLC

Language: Spanish
References: 18
Page:
PDF size: 224.12 Kb.


ABSTRACT

Hypothyroidism is the clinical syndrome characterized by the deficiency of thyroid hormone in the body. It causes changes in the connective tissue, which manifests as an increase in volume and edema in different parts of the body. Changes in the connective tissue can cause nerve compression syndromes in hypothyroid patients, with the carpal tunnel syndrome as the most frequently associated. This article presents the case of a patient with paresthesias in the right upper limb and low back pain with neuropathic characteristics which led to the diagnosis of carpal tunnel syndrome and sciatic neuropathy, respectively. Laboratory tests documented severe hypothyroidism and levothyroxine was subsequently started. Six weeks later, the patient presents complete resolution of paresthesias of the right upper limb and low back pain, which finally led to the diagnosis peripheral mixta lumbar neuropathy as manifestation of hypothyroidism.


REFERENCES

  1. Argente H, Álvarez M. Semiología Médica, fisiopatología, semiotecnia y propedéutica. 2da ed. Buenos Aires: Editorial Panamericana; 2013.

  2. Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, et al. Clinical practice guideline: Benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg. 01 de marzo, 2018 [citado el 20 de febrero, 2022];156(3):1–47. Doi: https://doi.org/10.1177/0194599816689667

  3. Wiersinga W. Myxedema and Coma (SevereHypothyroidism). En: Feingold KR, Anwalt B,Boyce A, et al. Endotext. South Dartmouth (MA):MDText.com; 2018 [cited May 02, 2022]. Availablefrom:https://www.ncbi.nlm.nih.gov/books/NBK279007/

  4. Scadding J, Koltzenburg M. Painful peripheralneuropathies. Wall and Melzack's Textbook ofPain; 2016 [cited May 02, 2022], 973-999. Doi:https://doi.org/10.1016/B0-443-07287-6/50067-9

  5. Waghmare S, Pajai S, Shende V, et al. Sensoryneuropathy in hypothyroidism: A case-controlstudy. Health; 2021 [cited May 02, 2022];3(3):3262-3265. Available from:https://www.ijcmr.com/uploads/7/7/4/6/77464738/ijcmr_1070_v1_dec_3.pdf

  6. Gupta S, Khadka R, Thakur D, Paudel B, et al.Correlation of nerve conduction study parameterswith thyroid hormone in newly diagnosedhypothyroid patients. Asian J Med Sci. 2021 [citedMay 02, 2022];12(11):139–42. Doi:https://doi.org/10.3126/ajms.v12i11.38955

  7. Meshram K, Meshram A. Nerve Conduction Studyin Early Diagnosed Cases of Hypothyroidism inCentral India. Indian Journal of Forensic Medicineand Toxicology. 2020 [cited May 02, 2022];14(4):7094-7101. Doi:https://doi.org/0.4103/jdmimsu.jdmimsu_158_20

  8. Jameson J, Mandel SJ, Weetman AP.Hypothyroidism. In: Barnes PJ, Longo DL, FauciAS. Harrison’s Principles of Internal Medicine, 20thed. McGraw Hill; 2018 [cited May 02, 2022].Available from:https://accessmedicine.mhmedical.com/content.aspx?bookid=2129§ionid=179924583

  9. Shiri R. Hypothyroidism and carpal tunnelsyndrome: A meta-analysis. Muscle & Nerve; 2014[cited May 02, 2022];50(6):879- 883. Doi:https://doi.org/10.1002/mus.24453

  10. Bahadur R, Sarkar A, Meesam M, Rasheed M. Acase of peripheral neuropathy due tohypothyroidism misdiagnosed as lumbarradiculopathy: A case report. Indian Journal ofPain; 2015 [cited May 02, 2022];29(3):181-184.Doi: https://doi.org/10.4103/0970-5333.165847

  11. Watson JC, Dyck PJ. Peripheral Neuropathy: APractical Approach to Diagnosis and SymptomManagement. Mayo Clinic Proceedings; 2015[cited May 03, 2022];90(7):940–51. Doi:https://doi.org/10.1016/j.mayocp.2015.05.004

  12. Hobson-Webb L, Juel V. Common EntrapmentNeuropathies. Continuum: Lifelong Learning inNeurology; 2017 [cited May 03, 2022];23(2):487-511. Doi:https://doi.org/10.1212/CON.0000000000000452

  13. Faraz A, Singhal S, Hossain M, Siddiqui S. Effectof Hypothyroidism on Motor Nerve ConductionStudies: A Cross Sectional Study. Annals ofInternational Medical and Dental Research; 2017[cited May 02, 2022];3:2. Doi:https://doi.org/10.21276/aimdr.2017.3.2.PH1

  14. Craig A. Entrapment Neuropathies of the LowerExtremity. PM&R; 2013 [cited May 04,2022];5:S31–40. Doi:https://doi.org/10.1016/j.pmrj.2013.03.029

  15. Abdelazeem M, ElZohiery A, Elhussieny M, RagaaiM. Subclinical Peripheral Nerve Affection inHypothyroidism. The Egyptian Journal of HospitalMedicine; 2017 [cited May 02, 2022];67(2):553–63.Doi: https://doi.org/10.12816/0037806

  16. Hennessey JV. The emergence of levothyroxine asa treatment for hypothyroidism. Endocrine; 2017[cited May 02, 2022];55:6–18. Doi:https://doi.org/10.1007/s12020-016-1199-8

  17. Chiovato L, Magri F, Carlé A. Hypothyroidism inContext: Where We've Been and Where We'reGoing. Advances in Therapy; 2019 [cited May 02,2022];36(2):47–58. Doi:https://doi.org/10.1007/s12325-019-01080-8

  18. Kasem A. Carpal Tunnel Syndrome in HypothyroidPatients: The Effect of Hormone ReplacementTherapy. American Journal of Internal Medicine;2014 [cited May 02, 2022];2(3):54. Doi:https://doi.org/10.11648/J.AJIM.20140203.14




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