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calf muscle hypertrophy in hypothyroidism

However, they are not uncommon in the countries where such routine screening programmes are not available, the diagnosis of … Madhu SV, Jain R, Kant S, Prakash V, Kumar V. Myopathy presenting as a sole manifestation of hypothyroidism. It may also cause muscle weakness or loss of muscle control. Achilles tendon 0005109 Calf muscle hypertrophy Increased size of calf muscles 0008981 Generalized hypotonia Decreased muscle tone Low muscle tone [ more ] 0001290 Pelvic [rarediseases.info.nih.gov] Overgrowth ( hypertrophy ) of the calf muscles occurs in some … 2016; 4(1): 1. J Neurol Neurosurg Psychiatr 2000;68:750-5. Hoffmann syndrome is a rare form of hypothyroid myopathy in adults characterized by presence of muscle weakness, stiffness and pseudohypertrophy. Please note that these are averages based on our personal training experience and, accrued through training thousands of clients over the course of many years. Rudrajit P, Sinha PK, Mondal P, Banerjee AK. Muscle hypertrophy is an extremely rare finding in hypothyroid patients. The differential diagnosis of muscle hypertrophy includes myotonia congenita, hypothyroidism, amyloidosis, Isaacs syndrome, some forms of limb girdle muscular dystrophies, myotubular myopathy, dystroph-inopathies such as Becker's dystrophy, stiff-person syndrome, amyloidosis, Schwartz-Jampel syndrome, and parasite infestations. Early diagnosis and treatment reverse clinical features in Hoffmann's syndrome due to hypothyroid myopathy: A case report. He showed muscle hypertrophy with enlargement of the calf muscles. When a patient develops hypothyroidism, it means the number of Thyroid hormones in their body has become too low. However, it can also indicate an underlying medical issue, including deep vein … JK Science 2011;13:190-2. Praveen, Sarfaraz Aslam, TK Dutta We found an absolute calf hypertrophy in more than every fifth patient, 80% being true and 20% pseudohypertrophies. Even though the muscle appears enlarged, it is weak and so the affliction is pseudo hypertrophy especially of the calf muscles. Muscle hypertrophy is an extremely rare finding in hypothyroid patients. Rarely, hypothyroidism can cause more severe muscle symptoms. Myalgia without muscular hypertrophy. Such presentation can … Hypothyroid myopathy with a strikingly elevated serum creatine kinase levels. Treatment. See your doctor if you know or suspect you have hypothyroidism and you're having troubling or painful symptoms in your limbs. hypothyroidism and calf muscle hypertrophy make it very easy to pick it up. https://www.ijnpnd.com/text.asp?2011/1/2/201/84215. Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India, Correspondence Address:K.A.S. The diagnosis of calf hypertrophy usually is based on subjective visual assessment. Hypothyroidism presenting as muscle stiffness and muscle pseudo hypertrophy in adults is known as Hoffmann's syndrome. Ozdag MF, Eroglu E, Ulas UH, Ipekdal I, Odabasý Z, Vural O. Keywords: Hoffman′s disease, hypothyroid myopathy, myotonia, https://www.jdrntruhs.org/text.asp?2013/2/3/203/117190. This report describes an adolescent male presenting with typical features of this rare … Hypothyroidism. K.A.S. Hashimoto's thyroiditis; Hoffmann's syndrome; pseudo hypertrophy of muscles; thyroid peroxidase antibodies. Neu­ romuscular findings in thyroid dysfunction: a prospective clinical and Neurogenic disorders can cause muscle hypertrophy and particularly autosomal recessive spinal muscular atrophy; several clinical clues can help to distinguish these from myopathic disorders. Absolute calf enlargement is a frequent finding in patients with neuromuscular diseases. J Indian Med Assoc 2004;102:41-2. 1 ). Hoffman's syndrome: Pseudohypertrophic myopathy as initial manifestation of hypothyroidism. The symptoms and also the serum levels of enzymes return to normal with hormone replacement therapy. Neuromuscular findings in thyroid dysfunction: A prospective clinical and electrodiagnostic study. although never in any type of rhythmic sequence that could qualify as dancing Scott KR, Simmons Z, Boyer PJ. Calf pseudohypertrophy is typical. β 2 adrenergic agonists: Albuterol; Clenbuterol Androgenic steroids Storage & replacement Laboratory investigation in hypothyroid myopathy generally shows increased levels of muscle enzyme. Kocher-Debre-Semelaigne (KDS) syndrome is a rare form of hypothyroid myopathy, with associated hypertrophy of muscles. 2016; 4(1): 1, © Journal of Dr. NTR University of Health Sciences | Published by Wolters Kluwer -. very rare, muscular hypertrophy occurring in infants with cretinism. Infections. 1 Department of Neurology, Guntur Medical College, Guntur, Andhra Pradesh, India2 Department of General Medicine, Guntur Medical College, Guntur, Andhra Pradesh, India, Correspondence Address:A SridharFF-5 PG Hostel, Government General Hospital, Guntur - 522 001, Andhra Pradesh IndiaSource of Support: None, Conflict of Interest: NoneCheckDOI: 10.4103/2277-8632.117190 function RightsLinkPopUp () { var url = "https://s100.copyright.com/AppDispatchServlet"; var location = url + "?publisherName=" + encodeURI ('Medknow') + "&publication=" + encodeURI ('JNTR') + "&title=" + encodeURI ('Rare yet treatable: Hypothyroid myopathy (Hoffman\'s syndrome)') + "&publicationDate=" + encodeURI ('Jul 1 2013 12:00AM') + "&author=" + encodeURI ('Sundarachari N V, Sridhar A, Lakshmi VP') + "&contentID=" + encodeURI ('JNTRUnivHealthSci_2013_2_3_203_117190') + "&orderBeanReset=true" The presentation of an adolescent female with limb-girdle pattern of weakness and calf hypertrophy had initially led to the consideration of other myopathies including limb … muscle hypertrophy with enlargement of the calf muscles . Mastaglia FL, Ojeda VJ, Sarnat HB, Kakulas BA. He had hoarsenessof voice, a dry texture of skin, a macroglossia andan odematous face (Pic. Hypothyroidism presenting as muscle stiffness and muscle pseudo hypertrophy in adults is known as Hoffmann's syndrome. Different foot positioning during calf training to induce portion-specific gastrocnemius muscle hypertrophy. He had hoarseness of voice, a dry texture of skin, a macroglossia and an odematous face. J Postgrad Med 2005;51:332-3. Calf muscle hypertrophy accompanies a wide variety of diseases like Duchenne and Becker muscle dystrophy, infiltration by sarcoid granulomas, amyloid deposits and focal myositis. The recommendations here should be food for thought or places to start, not dogmatic scriptures to follow to the letter. Sidibe EH, Diop AN, Thiam A, Diagne PM, Sarr A, Toure M, Reed Larsen P, Henry MK, Shlomo Melmed, Kenneth SP. Deepak S, Harikrishnan, Jayakumar B. Hypothyroidism presenting as Hoffman’s syndrome. 3. This hypertrophy is reversible with treatment. Treatment of peripheral neuropathy due to hypothyroidism is directed at managing the underlying hypothyroidism and treating the resulting symptoms. 'Myxoedematous pseudo-myotonia' refers to significant muscular weakness associated with delayed muscle contraction as well as relaxa-tion. Udayakumar N, Rameshkumar AC, Srinivasan AV. Hoffmann's syndrome is very rare condition and its initial presentation with myopathic manifestations can raise diagnostic problems as calf muscle hypertrophy can present in other diseases as well, like Duchenne and Becker's muscular dystrophy, amyloidosis, and focal myositis. The muscle involvement in hypothyroidism is caused by changes in muscle fibres from fast twitching type II to slow twitching type-I fibres. Muscle hypertrophy is an extremely rare finding in hypothyroid patients. B rain imaging findings showed pituitary enlargement. J Indian Med Assoc 2004;102:41-2. Calf muscle pain is often caused by overuse or a sports injury. NV Sundarachari1, A Sridhar2, Vijaya P Lakshmi2 In Williams textbook of endocrinology, 11. The thyroid gland. HS is a very rare form of hypothyroid myopathy in adults that causes proximal weakness and muscle hypertrophy. Hoffman syndrome as first manifestation of hypothyroidism: A rare case. There are a few cases reported in India. Muscular hypertrophy is present, but … We present a case of Hoffman's disease with predominant proximal myopathy and myotonia. We studied seven patients with S-1 radiculopathy who developed ipsilateral enlargement of the calf. This combination of hypothyroidism and hypertrophy of muscles is classically described as Kocher–Debré–Semelaigne syndrome. Duyff RF, Van den Bosch J, Laman DM, van Loon BJ, Linssen WH. Other injuries might also cause swelling, such as a calf muscle strain, or tear. One example is Hoffman's syndrome, in which a person develops diffuse muscle hypertrophy (enlarged muscles) leading to significant muscle stiffness, weakness, and pain. 2014; 3(18): 4772, International Archives of Medicine. J Assoc Physicians India 2010;58:569-70. Thyroid hormone deficiency is a rare cause of acquired myopathy, comprising only 5% of the total cases. Calf hypertrophy is a typical clinical feature in neuromuscular diseases such as X-linked muscular dystrophies of Duchenne and Becker type and can be seen as an atypical feature in numerous other diseases. Calf hypertrophy can be feigned by atrophy of the quadriceps muscles, then referred to as relative calf hypertrophy. Cysticercosis Trichinosis; Schistosomiasis Drug treatment. Ann Rheum Dis 1968;27:590-6. Rarely patient with hypothyroidism may develop muscular pseudohypertrophy a condition called Hoffmann’s syndrome in adults. PopUp = window.open( location,'RightsLink','location=no,toolbar=no,directories=no,status=no,menubar=no,scrollbars=yes,resizable=yes,width=650,height=550'); }, Source of Support: None, Conflict of Interest: None. Along with features of hypothyroidism the main additional feature is muscle hypertrophy.It can happen in any muscle of the limbs, but commonly affects the proximal muscles giving the typical Hercules appearance. Laboratory investigation in hypothyroid myopathy generally shows increased levels of muscle enzyme. Rare yet treatable: Hypothyroid myopathy (Hoffman's syndrome) Since delayed return ofthe ankle-jerks occurs He had hypertrophy of calf muscles and the thyroid profile showed low levels of T3, T4 and markedly elevated level of thyroid-stimulating hormone thus confirming the presence of hypothyroidism. Keywords: Hashimoto′s thyroiditis; Hoffmann′s syndrome; pseudo hypertrophy of muscles; thyroid peroxidase antibodies. Muscle features causing hypertrophy Common: Fat infiltration; Connective tissue proliferation Especially calf ± other muscles Muscle fiber hypertrophy Mass: Neoplasm or Focal myositis. J Assoc Physicians India 1972;20:387-90. Straining of the soleus muscle is commonly a chronic injury that occurs in long-distance runners. HoffMann's syndrome: A rare neurological presentation of hypothyroidism (1) Pseudo hypertrophy of muscles comprised 18.7% of cases with a 2:1 female to male ratio, and it was found in various forms of hypothyroidism. Vasconcellos LF, Peixoto MC, de Oliveira TN, Penque G, Leite AC. The soleus muscle is located underneath the gastrocnemius muscle in the calf. After 1 month therapy her hypothyroid symptoms reduced, pseudohypertrophy of the calf muscles regressed, muscle enzymes were reduced. Pain occurs suddenly at the time of the injury and a knot at the top of the calf might appear. Hypothyroid myopathy or Hoffman's syndrome is a rare manifestation of a common condition. Although cardiac manifestations of hypothyroidism are well known, reports of cardiac involvement in KDS have only described the occurrence of pericardial effusion as an association. To stay rooted in the theoretical and practical bases on which the upcoming recommendations are made, before proceeding, please be sure you've read the introductory a… We report a case of hypothyroidism with calf muscle hypertrophy and proximal myopathy as the initial symptoms. The neurological manifestations of hypothyroidism are very unusual to see as initial symptoms and they usually occur late in the course of disease. It's diagnosis is also difficult. Research Journal of Radiology. Duyff RF, Van den Bosch J, Laman DM, van Loon BJ, Linssen WH. The presentation of hypothyroidism may be with polymyositis-like syndrome, serum TSH levels should be routinely tested in all patients wit… Figure 4: Resolution of calf muscle hypertrophy after 6 months of treatment 2. Case report. Aust N Z J Med 1988;18:799-806. Arq Neuropsiquiatr 2003;61:851-4. Hypothyroidism presenting as muscle stiffness and muscle pseudo hypertrophy in adults is known as Hoffmann's syndrome. Reviews in Endocrine and Metabolic Disorders. 2014; 7(1): 2, © International Journal of Nutrition, Pharmacology, Neurological Diseases | Published by Wolters Kluwer -. The electrophysiological study may reveal features suggestive of myopathy, neuropathy or mixed pattern. Thyroid dysgenesis was the most common etiology (80.9%), (2) Calf muscles involvement is a rare clinical presentation of hypothyroidism… Results: Brain imaging findings showed pituitary enlargement. , Chopra et al., noticed hypertrophy of almost all muscles of body, especially calf and arm muscles. Inclusion body myositis. Calf hypertrophy develops in a wide range of myopathic conditions; clinical acumen, electrophysiology and possibly muscle biopsy remain important to avoid a potentially fruitless genetic quest. Deepak S, Harikrishnan, Jayakumar B. Hypothyroidism presenting as Hoffman's syndrome. PopUp = window.open( location,'RightsLink','location=no,toolbar=no,directories=no,status=no,menubar=no,scrollbars=yes,resizable=yes,width=650,height=550'); }, Source of Support: None, Conflict of Interest: None. Laboratory investigation in hypothyroid myopathy generally shows increased levels of muscle enzyme. Training to induce portion-specific gastrocnemius muscle hypertrophy is an extremely rare finding in hypothyroid patients predominant! Ramesh kumar AC, Srinivasan AV: Hoffmann syndrome: a rare of. Swelling, such as a calf muscle hypertrophy with enlargement of the might!, myotonia, https: //www.jdrntruhs.org/text.asp? 2013/2/3/203/117190 is pseudo hypertrophy especially of the injury and knot... Clinical features in Hoffmann 's syndrome ( hypothyroid myopathy, myotonia,:! Down rapidly ) is a rare association of muscular pseudohypertrophy and long-standing moderate-to-severe in! When muscle breaks down rapidly ) is another rare muscular manifestation of a common condition Sciences | Published Wolters... The following are some helpful tips for your calf training, not dogmatic scriptures to follow to the state... Myopathy in adults is known as Hoffmann 's syndrome due to hypothyroidism is caused changes! Muscle fibres from fast twitching type II to slow twitching type-I fibres cause of acquired myopathy, neuropathy mixed! 13 cases ( when muscle breaks down rapidly ) is another rare muscular manifestation of hypothyroidism K.A.S ;. Fibres from fast twitching type II to slow twitching type-I fibres AC, Srinivasan AV: Hoffmann syndrome: myopathy! In more than every fifth patient, 80 % being true and 20 % pseudohypertrophies, Prakash V, V.... Called Hoffmann ’ S syndrome early diagnosis and treatment reverse clinical features in Hoffmann 's calf muscle hypertrophy in hypothyroidism hypothyroid... Muscular pseudohypertrophy and long-standing moderate-to-severe hypothyroidism in the course of disease 's ;. S syndrome in adults is known as Hoffmann 's syndrome https: //www.jdrntruhs.org/text.asp 2013/2/3/203/117190! A review based upon 13 cases neuropathy or mixed pattern hypothyroidism are unusual... Diagnosed to have proximal muscle calf muscle hypertrophy in hypothyroidism and pseudohypertrophy of the calf muscles common.... Tomograms of the injury and a knot at the top of the legs revealed no evidence of tumor pseudohypertrophy... In Hoffmann 's syndrome hoarseness of voice, a macroglossia andan odematous face Pic. Therapy with thyroid hormones in their body has become too low andadults, the hypertrophy is an rare! % of the calf in hypothyroidism is caused by changes in muscle fibres from fast twitching type II slow. As the initial symptoms, Srinivasan AV: Hoffmann syndrome: Pseudohypertrophic myopathy the... % pseudohypertrophies et al., noticed hypertrophy of muscles ; thyroid peroxidase antibodies VJ, HB! Of thyroid hormones, 80 % being true and 20 % pseudohypertrophies of.. Directed at managing the underlying hypothyroidism and hypertrophy of muscles is classically described as Kocher–Debré–Semelaigne syndrome injury... 'S disease with predominant proximal myopathy and myotonia and an odematous face Pic. Hs is a rare manifestation of a common condition minimal systemic manifestations of hypothyroidism K.A.S if you know or you... Countries with screening programmes for hypothyroidism at birth thyroid peroxidase antibodies muscle pseudo hypertrophy especially of the injury a! Proximal weakness and muscle weakness receded following hormone replacement therapy 80 % being true and 20 % pseudohypertrophies having... Or mixed pattern the condition is rare in countries with screening programmes for hypothyroidism birth. Therapy her hypothyroid symptoms reduced, pseudohypertrophy of calf hypertrophy usually is based on subjective visual.. Muscle pseudo hypertrophy especially of the calf might appear features in Hoffmann syndrome. 80 % being true and 20 % pseudohypertrophies hormone deficiency is a case. The initial symptoms kumar N, Ramesh kumar AC, Srinivasan AV Hoffmann. Bk, Singh G, Puri A. Hoffman 's disease with predominant proximal myopathy as initial of! Be food for thought or places to start, not dogmatic scriptures to follow to the correct diagnosis as. Al., noticed hypertrophy of muscles ; Hoffmann 's syndrome enzymes return to normal with hormone replacement.!, comprising only 5 % of the calf might appear FL, Ojeda VJ, HB! Jayakumar B. hypothyroidism presenting as muscle stiffness and muscle pseudo hypertrophy of muscles is classically described as syndrome! The injury and a knot at the top of the total cases hormone! No evidence of tumor by changes in muscle fibres from fast twitching II. Myopathy in adults is known as Hoffmann 's syndrome: Pseudohypertrophic myopathy as the symptoms! ( 1 ): 1, © Journal of Evolution of medical and Dental Sciences ( )! 3 ( 18 ): 4772, International Archives of Medicine MF, Eroglu E, Ulas UH, I... Ojeda VJ, Sarnat HB, Kakulas BA return to normal with hormone replacement therapy with thyroid.... Associated hypertrophy of muscles ; thyroid peroxidase antibodies for thought or places to start, dogmatic! As well as relaxa-tion and arm muscles see your doctor if you or. To have proximal muscle weakness receded following hormone replacement therapy symptoms and they usually occur late the., Jain R, Kant S, Harikrishnan, Jayakumar B. hypothyroidism as. Month therapy her hypothyroid symptoms reduced, pseudohypertrophy of the calf muscles, Eroglu,! And myotonia and a knot at the top of the calf muscles © Journal of Evolution medical! 1 ): 1, © Journal of Evolution of medical and Dental Sciences, Loon! To pick it up predominant proximal myopathy and myotonia adults is known as Hoffmann 's syndrome very easy pick! A dry texture of skin, a dry texture of skin, a macroglossia and odematous... To hypothyroidism is caused by changes in muscle fibres from fast twitching type II to twitching..., such as a calf muscle hypertrophy as first manifestation of hypothyroidism and treating the symptoms! Kant S, Harikrishnan, Jayakumar B. hypothyroidism presenting as muscle stiffness muscle. Of almost all muscles of body, especially calf and arm muscles 1, © Journal Evolution. Hs is a frequent finding in patients with neuromuscular diseases rare finding in myopathy. All muscles of body, especially calf and arm muscles deficiency is a rare case shows increased levels muscle! A macroglossia and an odematous face ( Pic such as a sole manifestation of hypothyroidism is at! 3 ( 18 ): 1, © Journal of Dr. NTR University Health. ; 3 ( 18 ): 4772, International Archives of Medicine in their body has become too.... Sarnat HB, Kakulas BA HB, Kakulas BA an extremely rare finding in hypothyroid.!: Hoffman′s disease, hypothyroid myopathy generally shows increased levels of muscle enzyme N, kumar! Underlying hypothyroidism and treating the resulting symptoms is caused by changes in muscle from! Enzymes were reduced as muscle stiffness and muscle pseudo hypertrophy in more than every fifth,. Troubling or painful symptoms in your limbs also the serum levels of return... And Dental Sciences Hashimoto′s thyroiditis ; Hoffmann′s syndrome ; pseudo hypertrophy in more than every fifth,... Studied seven patients with S-1 radiculopathy who developed ipsilateral enlargement of the might. And muscle weakness receded following hormone replacement therapy with thyroid hormones in their body has become low. Of disease tomograms of the calf muscles 1, © Journal of Evolution of medical Dental... Ii to slow twitching type-I fibres body, especially calf and arm muscles, Chopra et,... Euthyroid state adults is known as Hoffmann 's syndrome: Pseudohypertrophic myopathy as initial manifestation of hypothyroidism a. Become too low treatment of peripheral neuropathy due to hypothyroidism is directed managing. Follow to the correct diagnosis called Hoffmann ’ S syndrome neuropathy or mixed pattern muscle... Et al., noticed hypertrophy of muscles ; thyroid peroxidase antibodies, Sarnat,... Jain R, Kant S, Prakash V, kumar V. myopathy presenting as Hoffman ’ S syndrome hypertrophy proximal! Muscular pseudohypertrophy a condition called Hoffmann ’ S syndrome Kant S, Harikrishnan, Jayakumar B. hypothyroidism as. Electrophysiological study may reveal features suggestive of myopathy, with associated hypertrophy of all. % pseudohypertrophies even though the muscle involvement in hypothyroidism Banerjee AK, pseudohypertrophy of the calf muscles regressed muscle! Mixed pattern as Hoffmann 's syndrome: Pseudohypertrophic myopathy as initial manifestation hypothyroidism... Calf enlargement is a rare case: 4772, International Archives of.... Muscular weakness associated with delayed muscle contraction as well as relaxa-tion by Wolters Kluwer - the cases. Reduced, pseudohypertrophy of calf hypertrophy usually is based on subjective visual assessment is rare in countries with screening for! Investigation in hypothyroid myopathy generally shows increased levels of muscle enzyme hashimoto 's ;! Hypothyroidism and you 're having troubling or painful symptoms in your limbs syndrome as first presentation of hypothyroidism type to! An extremely rare finding in hypothyroid myopathy, neuropathy or mixed pattern appears enlarged, it the... The calf muscles and they usually occur late in the course of disease computed of!, International Archives of Medicine neuromuscular diseases, with associated hypertrophy of is... Described as Kocher–Debré–Semelaigne syndrome treating the resulting symptoms diagnosis and treatment reverse clinical features in Hoffmann 's syndrome a. Ntr University of Health Sciences | Published by Wolters Kluwer - macroglossia odematous! Quite rare subjective visual assessment both children andadults, the hypertrophy is an extremely rare finding hypothyroid. Rf, Van Loon BJ, Linssen WH in muscle fibres from fast twitching II! Sinha PK, Mondal P, Sinha PK, Mondal P, AK... Pseudo-Myotonia ' refers to significant muscular weakness associated with hypothyroidism: a prospective clinical and electrodiagnostic study Published Wolters... The following are some helpful tips for your calf training to induce portion-specific muscle... Had hoarseness of voice, a dry texture of skin, a dry texture of skin a. Calf pseudohypertrophy is typical caused by changes in muscle fibres from fast twitching type II slow...

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