Reversible myopathy and renal impairment

In a patient with myopathy and renal impairment, a cause to be excluded is thyroid dysfunction. CASE HISTORY A man aged 39 was referred in March 1998 to our otolaryngology service with a new symptom of snoring, which was treated unsuccessfully by uvulopalatopharyngo-plasty a year later. Subsequently, in December 2000, he was referred to the regional renal unit with anorexia and lethargy associated with renal impairment. He was slightly short of breath and had experienced a change in his vision, necessitating glasses. On examination, he was normo-tensive. Creatinine was 189 mmol/L, urea 7.5 mmol/L, cholesterol 8.4 mmol/L. Other blood and urine tests, renal tract ultrasound and renal biopsy were normal. By May 2001, his creatinine had increased to 220 and his cholesterol