Elevation of serum creatine kinase during methimazole treatment of Graves disease in a 13-year-old girl and a literature review of similar cases

• প্রধান লেখক: Hyeseon Kim (Author), Jinsup Kim (Author), Rimm Huh (Author), Sung Yoon Cho (Author), Dong-Kyu Jin (Author)
• বিন্যাস: গ্রন্থ
• প্রকাশিত: Korean Society of Pediatric Endocrinology, 2015-06-01T00:00:00Z.
• বিষয়গুলি: article
• অনলাইন ব্যবহার করুন: Connect to this object online.
• Notes: 2287-1012; 2287-1292; 10.6065/apem.2015.20.2.106
• Keywords: Graves disease; Antithyroid drugs; Methimazole; Creatine kinase; Myalgia; Pediatrics; RJ1-570
• Source: Annals of Pediatric Endocrinology & Metabolism, Vol 20, Iss 2, Pp 106-109 (2015)

We report a 13-year-old girl with Graves disease, who showed an increased level of serum creatine kinase (CK) accompanied by myalgia after methimazole (MMI) treatment. This patient developed muscular pain two weeks after MMI administration, along with increased CK levels. The level of thyroid hormone was within the normal range when she showed increased CK levels. After the MMI dose was decreased and levo-thyroxine was added, serum CK levels decreased to normal and the myalgia improved. The pathophysiologic mechanism of this effect has not yet been elucidated. An acute relatively hypothyroid state occurs secondary to antithyroid drug (ATD) administration in chronic hyperthyroidism, which may cause changes in the CK levels. In this report, we present a rare pediatric case, along with a literature review of similar cases. In the initial state of MMI treatment, myalgia should be detected and when it occurs, CK levels should be measured. The clinical strategy of monitoring CK levels with the aim of normalizing thyroid hormones is helpful in case of the development of adverse reactions, such as myalgia, during ATD treatment for Graves disease in children.