Carpal Tunnel Syndrome in Hypothyroid Patients: The Effect of Hormone Replacement Therapy
American Journal of Internal Medicine
Volume 2, Issue 3, May 2014, Pages: 54-58
Received: May 9, 2014; Accepted: May 26, 2014; Published: Jun. 20, 2014
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Authors
Arafat A. Kasem, Department of Internal medicine, Faculty of Medicine, Al Azhar University, Cairo, Egypt
Sabry M. Fathy, Department of Neurology, Faculty of Medicine, Al Azhar University, Cairo, Egypt
Doaa A. Shahin, Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Amir A. Fikry, Department of Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Abstract
Objectives: To assess the electrodiagnostic evidence of median nerve dysfunction in newly diagnosed hypothyroid patients before and after hormone replacement therapy. Patients and methods: Fifty seven patients (fifty females and seven males) their age ranging from 23 to 61 years diagnosed with hypothyroidism,proved by thyroid hormone profile,were included in this study. Electrodiagnostic workup performed at the initial time of diagnosis and after 3 months including motor and sensory median nerve conduction studies in both right and left median nerves. Results: In our studied group, TSH levels were 30.77±23.51 IU/ mL before hormone replacement therapy and 5.25±1.72 IU/mL after the treatment. FT4 values were 9.2±1.54 pmol/l before treatment and 15.42±2.62pmol/l after treatment. FT3 levels were measured as 1.69±0.63Pmol/l at the diagnosis and 4.23±1.04 Pmol/l after treatment. The pre and post therapy levels difference of all previous parameters were statistically significant(P =0.001). Forty eight patients were normalized after treatment, while nine (13.8%) still had carpal tunnel syndrome symptoms. The differences between before treatment values of median nerve sensory and motor functions in both right and left median nerves respectively (sensory distal latency, sensory nerve conduction velocity, the sensory amplitude, the motor distal latency, the motor conduction velocity and the motor amplitude)(4.156±0.49 and 14.789±8.36 , 51.730±2.32 and 52.088±2.42, 28.123±8.52 and 25.193±5.74 , 4.404±0.66 and 4.393±0.61, 53.074±3.38 and 52.867±3.82 , 4.830±1.09 and 4.984±1.29 ) and after treatment values (3.365±0.44 and 3.561±0.46 , 63.649±2.16 and 63.035±3.56 , 33.123±7.16 and 29.280±5.39 , 3.674±0.52 and 3.767±0.46 , 64.193±2.79 and 63.789±4.00 , 5.368±1.18 and 5.488±1.19 ) were all significant (P =0.001). Conclusion: With hormonal replacement therapy, carpal tunnel syndrome can be reserved in patients with hypothyroidism within three months.
Keywords
Carpal Tunnel Syndrome, Hypothyroidism, Median Nerve
To cite this article
Arafat A. Kasem, Sabry M. Fathy, Doaa A. Shahin, Amir A. Fikry, Carpal Tunnel Syndrome in Hypothyroid Patients: The Effect of Hormone Replacement Therapy, American Journal of Internal Medicine. Vol. 2, No. 3, 2014, pp. 54-58. doi: 10.11648/j.ajim.20140203.14
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