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[Hypothyroid polyneuropathy in a patient with autoimmune polyglandular syndrome type 2: case report].
Arq Bras Endocrinol Metabol. 2014 Apr; 58(3):308-12.AB

Abstract

The incidence of polyneuropathy in patients with hypothyroidism is not precisely known, but some studies report that about 25% to 42% of patients may show neuropathic clinical signs. We report a case of autoimmune poliglandular syndrome type 2 (APS-2), whose initial presentation was hypothyroid polyneuropathy. A 41-year-old man complained of slowly progressive paresthesias and weakness affecting all four limbs, and associated with frequent drowsiness, weakness, cold intolerance, dizziness, nausea, and craving for salt. General physical examination showed hyperpigmentation of skin and mucous membranes, and hypotension. Neurological examination showed global, deep, and symmetrical hyporeflexia with slight signs of superficial hypoesthesia in the limbs. Electrodiagnostic studies (ENMG) together with laboratory tests, confirmed the suspicion of Hashimoto's thyroiditis associated with Addison's disease featuring the picture of APS-2. The patient was treated with fludrocortisone 0.05 mg/day and levothyroxine 100 mcg/day, and showed gradual and complete resolution of complaints. Changes were found in general physical and neurological examinations. ENMG repeated six months later showed complete resolution of neuropathy. This report shows a rare case of APS-2 presented as polyneuropathy hypothyroidism, and reinforces the importance of dosing thyroid hormone in polyneuropathy syndromes. Levothyroxine replacement was shown to be effective in reversing clinical and electrophysiologic neuropathy.

Authors+Show Affiliations

Universidade Federal de Campina Grande, Campina Grande, PB, Brasil.Universidade Federal de Campina Grande, Campina Grande, PB, Brasil.Universidade Federal de Campina Grande, Campina Grande, PB, Brasil.Universidade Federal de Campina Grande, Campina Grande, PB, Brasil.Universidade Federal de Campina Grande, Campina Grande, PB, Brasil.Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, PE, Brasil.Universidade Federal de Campina Grande, Campina Grande, PB, Brasil.Centro Universitário Cesmac, Maceió, AL, Brasil.Centro Universitário Cesmac, Maceió, AL, Brasil.Centro Universitário Cesmac, Maceió, AL, Brasil.

Pub Type(s)

English Abstract
Journal Article

Language

por

PubMed ID

24863095

Citation

Pascoal, Alysson Guimarães, et al. "[Hypothyroid Polyneuropathy in a Patient With Autoimmune Polyglandular Syndrome Type 2: Case Report]." Arquivos Brasileiros De Endocrinologia E Metabologia, vol. 58, no. 3, 2014, pp. 308-12.
Pascoal AG, Moreira EL, Faria AG, et al. [Hypothyroid polyneuropathy in a patient with autoimmune polyglandular syndrome type 2: case report]. Arq Bras Endocrinol Metabol. 2014;58(3):308-12.
Pascoal, A. G., Moreira, E. L., Faria, A. G., Leite, S. F., Pinto, I. H., Magalhães, J. E., Diniz, E. T., Canuto, J. M., Canuto, V. M., & Ferreira, S. M. (2014). [Hypothyroid polyneuropathy in a patient with autoimmune polyglandular syndrome type 2: case report]. Arquivos Brasileiros De Endocrinologia E Metabologia, 58(3), 308-12.
Pascoal AG, et al. [Hypothyroid Polyneuropathy in a Patient With Autoimmune Polyglandular Syndrome Type 2: Case Report]. Arq Bras Endocrinol Metabol. 2014;58(3):308-12. PubMed PMID: 24863095.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Hypothyroid polyneuropathy in a patient with autoimmune polyglandular syndrome type 2: case report]. AU - Pascoal,Alysson Guimarães, AU - Moreira,Ethyenne Lacerda, AU - Faria,Aline Guimarães de, AU - Leite,Suzana F B, AU - Pinto,Iurhi H G P, AU - Magalhães,João Eudes, AU - Diniz,Erik Trovão, AU - Canuto,Juliana Maria Palmeira, AU - Canuto,Virginia Maria Palmeira, AU - Ferreira,Sonia Maria Soares, PY - 2013/09/21/received PY - 2013/11/23/accepted PY - 2014/5/28/entrez PY - 2014/5/28/pubmed PY - 2015/4/14/medline SP - 308 EP - 12 JF - Arquivos brasileiros de endocrinologia e metabologia JO - Arq Bras Endocrinol Metabol VL - 58 IS - 3 N2 - The incidence of polyneuropathy in patients with hypothyroidism is not precisely known, but some studies report that about 25% to 42% of patients may show neuropathic clinical signs. We report a case of autoimmune poliglandular syndrome type 2 (APS-2), whose initial presentation was hypothyroid polyneuropathy. A 41-year-old man complained of slowly progressive paresthesias and weakness affecting all four limbs, and associated with frequent drowsiness, weakness, cold intolerance, dizziness, nausea, and craving for salt. General physical examination showed hyperpigmentation of skin and mucous membranes, and hypotension. Neurological examination showed global, deep, and symmetrical hyporeflexia with slight signs of superficial hypoesthesia in the limbs. Electrodiagnostic studies (ENMG) together with laboratory tests, confirmed the suspicion of Hashimoto's thyroiditis associated with Addison's disease featuring the picture of APS-2. The patient was treated with fludrocortisone 0.05 mg/day and levothyroxine 100 mcg/day, and showed gradual and complete resolution of complaints. Changes were found in general physical and neurological examinations. ENMG repeated six months later showed complete resolution of neuropathy. This report shows a rare case of APS-2 presented as polyneuropathy hypothyroidism, and reinforces the importance of dosing thyroid hormone in polyneuropathy syndromes. Levothyroxine replacement was shown to be effective in reversing clinical and electrophysiologic neuropathy. SN - 1677-9487 UR - https://wwww.unboundmedicine.com/medline/citation/24863095/[Hypothyroid_polyneuropathy_in_a_patient_with_autoimmune_polyglandular_syndrome_type_2:_case_report]_ L2 - http://www.diseaseinfosearch.org/result/685 DB - PRIME DP - Unbound Medicine ER -