Hoffman’s syndrome presenting as sole manifestation of hypothyroidism: A rare entity

Abstract

Myopathy is commonly seen in hypothyroidism. The most common symptoms include muscle cramps, weakness, and myalgia. Occasionally, hypertrophy of muscles may be seen which commonly involves muscles of tongue, thigh, and leg. The syndrome encompassing these clinical features is called as Hoffman’s syndrome. It is commonly associated with symptoms suggestive of other systemic manifestations of hypothyroidism such as cold intolerance, constipation, and delayed deep tendon reflexes. Laboratory investigation abnormalities such as dyslipidemia, low voltage complex, and pericardial effusion are also commonly associated. Hoffman’s syndrome as the only presentation of hypothyroidism in the absence of other symptoms and in the absence of other laboratory abnormalities is very rare. We present here an extremely rare case of Hoffman’s syndrome as the only manifestation of hypothyroidism in the absence of other systemic and laboratory abnormalities.