Skip to main content

Advertisement

SpringerLink
Log in

Dysphagia as a Manifestation of Thyrotoxicosis: Report of ThreeCases and Literature Review

  • Case Report
  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

Myopathy is frequently associated with thyrotoxicosis. Skeletal muscles are predominantly involved in thyrotoxic myopathy, but dysphagia is extremely rare. We report three cases of thyrotoxicosis with dysphagia and review of the literature of the past 30 years. Most of these patients had antecedent muscle weakness before the onset of dysphagia although some suffered from a sudden onset of bulbar palsy. Either a myopathic or neuropathic pattern was found on electromyography. The incidence of oropharyngeal dysphagia was higher than that of esophageal motility dysfunction. Aspiration pneumonia occurred more accompanied by oropharyngeal dysphagia. The swallowing disorder could be resolved completely within 3 weeks after treatment for thyrotoxicosis. In light of these clinical experiences, early intensive treatment that includes antithyroid agent, beta-blocker, and Lugol solution may be necessary.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. ID Ramsay (1966) ArticleTitleMuscle dysfunction in hyperthyroidism Lancet 2 931–934 Occurrence Handle10.1016/S0140-6736(66)90536-8 Occurrence Handle1:STN:280:CCiD383mvVE%3D Occurrence Handle4162369

    Article  CAS  PubMed  Google Scholar 

  2. I Ramsay (1968) ArticleTitleThyrotoxic muscle disease Postgrad Med J 44 385–397 Occurrence Handle1:STN:280:CCeB2sbotFE%3D Occurrence Handle4871773

    CAS  PubMed  Google Scholar 

  3. RF Duyff J den Bosch ParticleVan DM Laman BJ Loon Particlevan WH Linssen (2000) ArticleTitleNeuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study J Neurol Neurosurg Psychiatry 68 750–755 Occurrence Handle10.1136/jnnp.68.6.750 Occurrence Handle1:STN:280:DC%2BD3c3ntF2ltQ%3D%3D Occurrence Handle10811699

    Article  CAS  PubMed  Google Scholar 

  4. R Garzon JM Murphy (2002) ArticleTitleAcute bulbar muscle dysfunction in hyperthyroidism Conn Med 66 3–6 Occurrence Handle11852735

    PubMed  Google Scholar 

  5. A Lleo J Sanahuja C Serrano R Rojas I Illa (1999) ArticleTitleAcute bulbar weakness: thyrotoxicosis or myasthenia gravis? Ann Neurol 46 434–435 Occurrence Handle10.1002/1531-8249(199909)46:3<434::AID-ANA25>3.0.CO;2-D Occurrence Handle1:STN:280:DyaK1MvhtVSjtA%3D%3D Occurrence Handle10482280

    Article  CAS  PubMed  Google Scholar 

  6. GM Kammer CR Hamilton SuffixJr (1974) ArticleTitleAcute bulbar muscle dysfunction and hyperthyroidism. A study of four cases and review of the literature Am J Med 56 464–470 Occurrence Handle10.1016/0002-9343(74)90477-X Occurrence Handle1:STN:280:CSuC38bmtVY%3D Occurrence Handle4818413

    Article  CAS  PubMed  Google Scholar 

  7. P Marks J Anderson R Vincent (1980) ArticleTitleThyrotoxic myopathy presenting as dysphagia Postgrad Med J 56 669–670 Occurrence Handle1:STN:280:Bi6C38vmtl0%3D Occurrence Handle7465479

    CAS  PubMed  Google Scholar 

  8. D Branski J Levy M Globus I Aviad A Keren I Chowers (1984) ArticleTitleDysphagia as a primary manifestation of hyperthyroidism J Clin Gastroenterol 6 437–440 Occurrence Handle1:STN:280:BiqD2MnhtVw%3D Occurrence Handle6501830

    CAS  PubMed  Google Scholar 

  9. A Alshekhlee HJ Kaminski RL Ruff (2002) ArticleTitleNeuromuscular manifestations of endocrine disorders Neurol Clin 20 35–58 Occurrence Handle11754301

    PubMed  Google Scholar 

  10. Assessment of Iodine Deficiency Disorders and Monitoring their Elimination, Geneva: World Health Organization, Document WHO/NHD/01.1. 2001, p 39

  11. A Joasoo IP Murray AW Steinbeck (1970) ArticleTitleInvolvement of bulbar muscles in thyrotoxic myopathy Australas Ann Med 19 338–340 Occurrence Handle1:STN:280:CS6D28ngvFE%3D Occurrence Handle5490661

    CAS  PubMed  Google Scholar 

  12. H Noto T Mitsuhashi S Ishibashi S Kimura (2000) ArticleTitleHyperthyroidism presenting as dysphagia Intern Med 39 472–473 Occurrence Handle1:STN:280:DC%2BD3cvpt1OktA%3D%3D Occurrence Handle10852166

    CAS  PubMed  Google Scholar 

  13. MC Sweatman L Chambers (1985) ArticleTitleDisordered oesophageal motility in thyrotoxic myopathy Postgrad Med J 61 619–620 Occurrence Handle1:STN:280:BiqB2s%2Fhs1I%3D Occurrence Handle4022894

    CAS  PubMed  Google Scholar 

  14. AP Harrison T Clausen (1998) ArticleTitleThyroid hormone-induced upregulation of Na+ channels and Na(+)– K+ pumps: implications for contractility Am J Physiol 274 R864–867 Occurrence Handle1:CAS:528:DyaK1cXitVSitL4%3D Occurrence Handle9530256

    CAS  PubMed  Google Scholar 

  15. T Clausen OB Nielsen AP Harrison JA Flatman K Overgaard (1998) ArticleTitleThe Na+, K+ pump and muscle excitability Acta Physiol Scand 162 183–190 Occurrence Handle10.1046/j.1365-201X.1998.0295e.x Occurrence Handle1:CAS:528:DyaK1cXitlGqt7w%3D Occurrence Handle9578364

    Article  CAS  PubMed  Google Scholar 

  16. OB Nielsen AP Harrison (1998) ArticleTitleThe regulation of the Na+, K+ pump in contracting skeletal muscle Acta Physiol Scand 162 191–200 Occurrence Handle10.1046/j.1365-201X.1998.00297.x Occurrence Handle1:CAS:528:DyaK1cXitlGqt70%3D Occurrence Handle9578365

    Article  CAS  PubMed  Google Scholar 

  17. J Feely N Peden (1984) ArticleTitleUse of beta-adrenoceptor blocking drugs in hyperthyroidism Drugs 27 425–446 Occurrence Handle1:STN:280:BiuB3cjlvFw%3D Occurrence Handle6144501

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine, College of Medicine, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan

    Wei-Yih Chiu MD, I-Chueh Huang MD & Tien-Shang Huang MD

  2. Department of Neurology, College of Medicine, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan

    Chih-Chao Yang MD

Authors
  1. Wei-Yih Chiu MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chih-Chao Yang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. I-Chueh Huang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tien-Shang Huang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tien-Shang Huang MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chiu, WY., Yang, CC., Huang, IC. et al. Dysphagia as a Manifestation of Thyrotoxicosis: Report of ThreeCases and Literature Review. Dysphagia 19, 120–124 (2004). https://doi.org/10.1007/s00455-003-0510-z

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-003-0510-z

Keywords

Search

Navigation