eMedicine Specialties > Neurology > Neuromuscular Diseases

Endocrine Myopathies: Follow-up

Author: Wayne E Anderson, DO, Assistant Professor of Internal Medicine/Neurology, Western University of Health Sciences; Assistant Professor of Family Medicine, Touro University College of Osteopathic Medicine; Consulting Staff in Pain Management, Department of Neurology, California Pacific Medical Center
Coauthor(s): Ling Xu, MD, Director, Assistant Professor of Neurology, Neuromuscular Clinic and Pathology Lab, Saint Louis University Health Science Center
Contributor Information and Disclosures

Updated: Mar 13, 2007

Follow-up

Complications

  • Hyperthyroidism, hypothyroidism, and other endocrine states may be fatal.
  • Myopathy may be painful, and the pain must be addressed either in the form of symptomatic therapies or curative treatment of the endocrine diseases.

Prognosis

  • Prognosis depends on the underlying endocrine process. Myopathy often abates with correction of underlying disease.
  • Prolonged weakness and partial recovery are common especially in severe cases and in patients with delayed or suboptimal treatment.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Physicians must be alert to the possibility of an endocrine etiology in cases of pure muscle weakness—even in the absence of systemic findings—as endocrine diseases may be associated with significant morbidity or mortality.
  • Siafakas et al reported evidence of respiratory muscle weakness in endocrine disease.
  • Physicians must be alert to the possibility of an endocrine etiology in cases of new-onset psychosis or behavior disturbance.
  • Physicians must be alert to the possibility of malignancy as the underlying etiology for any endocrinopathy.
 


More on Endocrine Myopathies

Overview: Endocrine Myopathies
Differential Diagnoses & Workup: Endocrine Myopathies
Treatment & Medication: Endocrine Myopathies
Follow-up: Endocrine Myopathies
References
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References

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  2. Benvenga S, Toscano A, Rodolico C, et al. Endocrine evaluation for muscle pain. J R Soc Med. Aug 2001;94(8):405-7. [Medline].

  3. Engel AG, Fransini-Armstrong C. Endocrine myopathies. In: Myology. Vol 2. McGraw-Hill;1994:1726-47.

  4. Engel AG. Electron microscopic observations in primary hypokalemic and thyrotoxic periodic paralyses. Mayo Clin Proc. Nov 1966;41(11):797-808. [Medline].

  5. Engel AG, Fransini-Armstrong C, eds. Endocrine myopathies. In: Myology. 2nd ed. McGraw-Hill;1994.

  6. Fenichel GM. Clinical Pediatric Neurology: A Signs and Symptoms Approach. 2nd ed. WB Saunders Co;1993.

  7. Ghilardi G, Gonvers JJ, So A. Hypothyroid myopathy as a complication of interferon alpha therapy for chronic hepatitis C virus infection. Br J Rheumatol. Dec 1998;37(12):1349-51. [Medline].

  8. Godby A, Bergstresser PR, Chaker B, Pandya AG. Fatal scleromyxedema: report of a case and review of the literature. J Am Acad Dermatol. Feb 1998;38(2 Pt 2):289-94. [Medline].

  9. Horak HA, Pourmand R. Endocrine myopathies. Neurol Clin. Feb 2000;18(1):203-13. [Medline].

  10. Ikeda H, Yoshimoto T, Ogawa Y, et al. Clinico-pathological study of Cushing''s disease with large pituitary adenoma. Clin Endocrinol (Oxf). Jun 1997;46(6):669-79. [Medline].

  11. Imrich R, Bosak V, Rovensky J. Polymyalgia rheumatica and temporal arteritis: the endocrine relations and the pathogenesis. Review. Endocr Regul. Sep 2006;40(3):83-9. [Medline].

  12. Mastaglia FL. Endocrine myopathies. In: Lord Walton of Detchant, ed. Skeletal Muscle Pathology. 2nd ed. Churchill Livingstone;1992:493-509.

  13. Mastaglia FL. Endocrine myopathies In: Skeletal Muscle Pathology. Churchill Livingstone;1992.

  14. McNab TL, Khandwala HM. Acromegaly as an endocrine form of myopathy: case report and review of literature. Endocr Pract. Jan-Feb 2005;11(1):18-22. [Medline].

  15. Ohkoshi N, Ishii A, Shiraiwa N, et al. Dysfunction of the hypothalamic-pituitary system in mitochondrial encephalomyopathies. J Med. 1998;29(1-2):13-29. [Medline].

  16. Poirier J, Gray F, Escourolle R. Manual of Basic Neuropathology. WB Saunders Co;1990.

  17. Pourmand R. Metabolic myopathies. A diagnostic evaluation. Neurol Clin. Feb 2000;18(1):1-13. [Medline].

  18. Rodolico C, Toscano A, Benvenga S, et al. Myopathy as the persistently isolated symptomatology of primary autoimmune hypothyroidism. Thyroid. Nov 1998;8(11):1033-8. [Medline].

  19. Saguil A. Evaluation of the patient with muscle weakness. Am Fam Physician. Apr 1 2005;71(7):1327-36. [Medline].

  20. Schapira AH, Griggs RC. Endocrine myopathies. In: Muscle Disease. Vol 6. Butterworth-Heinemann;2000:181-92.

  21. Siafakas NM, Alexopoulou C, Bouros D. Respiratory muscle function in endocrine diseases. Monaldi Arch Chest Dis. Apr 1999;54(2):154-9. [Medline].

  22. Van Linthoudt D, Schumacher HR Jr, Algeo S, et al. Scleromyxedema with myopathy and hyperthyroidism. J Rheumatol. Jul 1996;23(7):1299-301. [Medline].

  23. al-Lozi MT, Pestronk A, Lee WC, et al. Rapidly evolving myopathy with myosin-deficient muscle fibers. Ann Neurology. Mar 1994;35(3):257-9. [Medline].

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Further Reading

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Keywords

endocrine myopathy, adrenal dysfunction, Cushing disease, Cushing syndrome, steroid myopathy, thyroid dysfunction, myxedema coma, thyrotoxic myopathy, parathyroid dysfunction, multiple endocrine neoplasia, pituitary dysfunction, islands of Langerhans dysfunction, diabetic myopathy, ischemic infarction of the femoral muscles, hypoadrenalism, muscle weakness, adrenal insufficiency, hyperadrenalism, thyroid hormone deficiency, hypoparathyroidism, hyperparathyroidism, hypopituitarism, hyperpituitarism, hyperparathyroid myopathy, hyperthyroid myopathy, iatrogenic steroid myopathy, hypothyroid myopathy, Cushing myopathy

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Contributor Information and Disclosures

Author

Wayne E Anderson, DO, Assistant Professor of Internal Medicine/Neurology, Western University of Health Sciences; Assistant Professor of Family Medicine, Touro University College of Osteopathic Medicine; Consulting Staff in Pain Management, Department of Neurology, California Pacific Medical Center
Wayne E Anderson, DO is a member of the following medical societies: American Academy of Neurology, American Academy of Pain Medicine, American Medical Association, American Society of Law Medicine and Ethics, California Medical Association, and San Francisco Medical Society
Disclosure: Cephalon Honoraria Speaking and teaching; Janssen Honoraria Speaking and teaching; Ligand Honoraria Consulting; Alpharma Honoraria Speaking and teaching

Coauthor(s)

Ling Xu, MD, Director, Assistant Professor of Neurology, Neuromuscular Clinic and Pathology Lab, Saint Louis University Health Science Center
Ling Xu, MD is a member of the following medical societies: American Association of Neuromuscular and Electrodiagnostic Medicine
Disclosure: Nothing to disclose.

Medical Editor

Dianna Quan, MD, Director, Electromyography Laboratory, Department of Neurology, Assistant Professor, University of Colorado Health Sciences Center
Dianna Quan, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Neil A Busis, MD, Chief, Division of Neurology, Department of Medicine, University of Pittsburgh Medical Center - Shadyside, Clinical Associate Professor, Department of Neurology, University of Pittsburgh School of Medicine
Neil A Busis, MD is a member of the following medical societies: American Academy of Neurology and American Association of Neuromuscular and Electrodiagnostic Medicine
Disclosure: Nothing to disclose.

CME Editor

Matthew J Baker, MD, Consulting Staff, Collier Neurologic Specialists, Naples Community Hospital
Matthew J Baker, MD is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

Chief Editor

Nicholas Y Lorenzo, MD, Chief Editor, eMedicine Neurology; Consulting Staff, Neurology Specialists and Consultants
Nicholas Y Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Neurology
Disclosure: Nothing to disclose.

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