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La miopatia ipotiroidea

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Riassunto

Sintomi suggestivi di sofferenza muscolare (rigidità, crampi, facile stancabilità) sono riferiti da gran parte dei pazienti affetti da ipotiroidismo franco. Talvolta la sintomatologia muscolare domina il quadro clinico o addirittura può presentarsi quale unica manifestazione di esordio dell’ipotiroidismo, per cui la diagnosi differenziale con altre cause di miopatia diventa difficoltosa. La patogenesi della miopatia ipotiroidea non è del tutto nota anche se è verosimile che i suoi meccanismi siano: alterato metabolismo glicogenolitico e ossidativo, alterata espressione di proteine contrattili, danno neuro-mediato. Studi di correlazione aplotipica, di espressione genica muscolare e di caratterizzazione proteica, potrebbero aiutare la comprensione dei meccanismi fisiopatologici di questa, spesso sottostimata, presentazione miopatica dell’ipotiroidismo. Il riscontro di elevati valori sierici di creatinfosfochinasi è sicuramente suggestivo di una compromissione muscolare, senza perb specificarne l’eziologia. Oltre a tale non specificità, l’ipercreatinchinasemia non correla con la gravita della sintomatologia miopatica. Manifestazioni muscolari rare, associate all’ipotiroidismo, sono la rabdomiolisi, la sindrome compartimentale acuta, e le sindromi di Hoffman e di Kocher-Debrè-Semelaigne.

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Authors and Affiliations

  1. Dipartimento di Neuroscienze, Psichiatria ed Anestesiologia, A.O.U. “G. Martino”, Università di Messina, Messina, Italia

    Carmelo Rodolico & Simona Portaro

  2. Sezione di Endocrinologia, Dipartimento di Medicina Clinica e Sperimentale, Policlinico Universitario, Via Consolare Valeria 1, 98125, Messina, Italia

    Maria Angela Pappalardo &  Salvatore Benvenga

  3. Master in Endocrinologia dell’infanzia, dell’adolescenza e della donna, Università di Messina, Messina, Italia

    Salvatore Benvenga

  4. Programma Interdisciplinare di Endocrinologia Molecolare Clinica e Salute Endocrina della Donna, A.O.U. Policlinico “G. Martino”, Messina, Italia

    Salvatore Benvenga

Authors
  1. Carmelo Rodolico
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  2. Maria Angela Pappalardo
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  3. Simona Portaro
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  4. Salvatore Benvenga
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Correspondence to Salvatore Benvenga.

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Rodolico, C., Pappalardo, M.A., Portaro, S. et al. La miopatia ipotiroidea. L’Endocrinologo 12, 281–287 (2011). https://doi.org/10.1007/BF03344855

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