Morphological Changes of Median Nerve in Patients with Newly Diagnosed, Untreated Autoim­mune Hypothyroidism

Authors: D. Holováčová;  M. Kužma;  Z. Killinger;  J. Payer
Authors‘ workplace: V. interná klinika LF UK a UN Bratislava
Published in: Cesk Slov Neurol N 2016; 79/112(4): 440-444
Category: Short Communication


The purpose of this study was to monitor ultrasound-detectable changes of median nerve in transverse section level of the carpal tunnel in hypothyroid patients with newly diagnosed, untreated autoimmune hypothyreosis.

Material and methods:
A cross sectional comparative study of patients with newly-diagnosed primary autoimunne hypothyroidism, where transverse section breadth of the median nerve in its entrance to the carpal tunnel (CSA) was measured. Values were compared with a control group of healthy subjects. Differences were statistically evaluated by unpaired t-test.

Absolute number of patients included in the study was 44 (ø age 52.8 years, 14 males/30 females, ø BMI 24.542 kg/m2, ø TSH 22.815 mU/l, fT4 11.756 pmol/l). The control group consisted of 44 subjects (ø age 52.57 years, 14 males/30 females, ø BMI 24.52 kg/m2, ø TSH 2.31 mU/l, ø fT4 16,397 pmol/l). CSA was significantly higher in patients (ø 0.098 cm2) compared to controls (ø 0.072 cm2, p < 0.001). In two hypothyroid patients, pathological increase of CSA (> 0.11 cm2) was in accordance with symptomatology of the carpal tunnel syndrome.

Ultrasound findings documented occurrence of subclinical and clinical carpal tunnel syndrome in patients with primary hypothyroidism. If carpal tunnel syndrome occurs, thyroidal status should be evaluated to exclude possible hypothyroidism. Cross sectional area of median nerve evaluation with high frequency ultrasound could be considered an alternative modality for early detection of this neuropathy in patients with hypothyroidism.

Key words:
carpal tunnel syndrome – hypothyroidism – ultrasound

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.


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