A case of Hypothyroidism with associated Scleroderma and Eczema

Background: This case report describes an unusual case of hypothyroidism as the symptoms especially fatigue, body aches and pain in hands of our patient didn’t improve despite adequate treatment with thyroxine, on further evaluation we found associated autoimmune disease scleroderma and eczema. There was significant improvement in symptoms of the patient after starting treatment for scleroderma. The association of hypothyroidism with systemic sclerosis is quite rare with only few cases reported from Pakistan, although cases of Localized scleroderma (Morphoea) with hypothyroidism have been reported but cases of hypothyroidism with systemic sclerosis (diffuse scleroderma) is uncommon with only few cases reported from Pakistan. Our case is unique due to the fact that patient had scleroderma, autoimmune thyroiditis and skin involvement (eczema). Case presentation: A 33 year old female diagnosed case of hypothyroidism was on levothyroxine for hypothyroidism however despite achieving euthyroid status, her symptoms including fatigue, body aches and skin lesions were not improving. So, we decided to evaluate her for any associated autoimmune illness. On further inquiry she also mentioned pain in hands and bluish discoloration of fingers especially while exposure to cold. Autoimmune workup confirmed associated Scleroderma and symptoms of patient improved significantly after starting treatment of Scleroderma. Conclusion: In patients with Hypothyroidism when there is no improvement in symptoms despite euthyroid levels, associated autoimmune disorder should be evaluated.