In:
Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 101, No. 39 ( 2022-09-30), p. e30834-
Abstract:
We investigated the factors associated with serum muscle enzyme elevation in patients with Sheehan’s syndrome. A total of 48 patients who were newly diagnosed with Sheehan’s syndrome were included and divided into 3 groups: Group 1, creatine kinase (CK) ≥ 1000 U/L; Group 2, 140 〈 CK 〈 1000 U/L; and Group 3, CK ≤ 140 U/L. Differences in serum muscle enzymes, serum electrolytes, blood glucose and hormones were compared among the 3 groups. A Spearman correlation analysis and multiple linear regression analysis were performed on serum muscle enzymes and the other variables. Four patients in Group 1 underwent electromyography. Fourteen, 26 and 8 patients were divided into Group 1, Group 2, and Group 3, respectively. The levels of plasma osmolality, serum sodium, free triiodothyronine (FT3) and free thyroxine (FT4) in Group 1 were lower than those in Group 3 at admission ( P 〈 .05). There were significant differences in CK, CK-MB, aspartate aminotransferase, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase among the three groups ( P 〈 .05). CK was correlated with serum sodium ( r = −0.642, P 〈 .001), serum potassium ( r = −0.29, P = .046), plasma osmolality ( r = −0.65, P 〈 .001), FT3 ( r = −0.363, P = .012), and FT4 ( r = −0.450, P = .002). Moreover, creatine kinase isoenzyme-MB (CK-MB) was correlated with serum sodium ( r = −0.464, P = .001) and plasma osmolality ( r = −0.483, P 〈 .001). The multiple linear regression showed that serum sodium was independently and negatively correlated with CK ( r = −0.352, P = .021). The electromyogram results supported the existence of myogenic injury. Sheehan’s syndrome is prone to be complicated by nontraumatic rhabdomyolysis, with both a chronic course and acute exacerbation. Serum muscle enzymes should be routinely measured. For patients with CK levels 〉 1000 U/L, a CK-MB/CK ratio 〈 6% can be a simple indicator to differentiate rhabdomyolysis from acute myocardial infarction. Abnormal serum muscle enzymes observed in Sheehan’s syndrome may be associated with hypothyroidism and with hyponatremia in particular.
Type of Medium:
Online Resource
ISSN:
1536-5964
DOI:
10.1097/MD.0000000000030834
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2022
detail.hit.zdb_id:
2049818-4
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