Swallowing Difficulty due to Hypothyroid Myopathy: A Case Report / 대한연하장애학회지

ABSTRACT

Musculoskeletal symptoms, such as muscle weakness, stiffness and pain, are observed frequently in patients with hypothyroidism. In theory, hypothyroidism can cause weakness of the swallowing muscles, but dysphagia associated with hypothyroidism-associated myopathy has not been reported. The present case involved a 51-year-old man who experienced acute onset of severe dysphagia with aspiration pneumonia. A video fluoroscopic swallowing study and fiberoscopic endoscopic evaluation of swallowing revealed pharyngo-laryngeal function impairment. With a prior history of subclinical hypothyroidism and clinical symptoms such as proximal limb weakness, further evaluation involving a hormonal study, electrodiagnostic study, and histopathology assessment revealed myopathy. Hormone replacement therapy was started and the patient recovered within three weeks of treatment and was taking a regular diet. In conclusion, this study suggests that it is necessary to consider further evaluations to determine if hypothyroid myopathy is involved in the case of unknown origin dysphagia accompanied by hypothyroid myopathy.