Elevation Of Serum Creatine Kinase During Treatment With Methimazole In A Patient With Hyperthyroidism Due To Graves Disease: A Case Report And Review Of The Literature

ObjectiveTo report a case and to review the literature of elevation of serum creatine kinase during treatment with methimazole in graves disease, including its etiological factor, clinical symptom, diagnosis, differential diagnosis, treatment and prognosis. Through the deepened cognition of such novel side effect of methimazole, we can make early diagnosis and treatment such disease prompty. MethodsTo describe the clinical data means of patient who suffered from graves disease and whose serum creatine kinase was elevated during treatment with methimazole, and review the literature to find out the similarity of all cases in aspect of etiological factors, mechanisms, clinical symptom, diagnosis, treatment and prognosis. ResultsThe patient sufferd from muscular soreness, elevation of serum creatine kinase. The antinuclear antibody was negative, the thyroid function did not hint hypothyroidism, the electromyography noted the change from muscles injure. The patient prognosis was good after decreasing the dose of methimazole or the administration of levothyroxine. ConclusionsThe side affect of methimazole was relatively rare. The mechanisms are not obvious, but it is likely that the rapid decrease of thyroid hormones in tissues may temporarily cause hypothyroid states, resulting in alterations in creatine kinase concentrations. It is also possibly collected with direct damage and immuno- suppressive of the drug. The patient prognosis was good after decreasing the dose of methimazole or the administration of levothyroxine. The side affect is related with the dose of the administration scheme. It is suggested that hasty correction of thyrotoxicosis should be avoided in susceptible patients, unless the thyrotoxic conditions are critical.