Potassium chloride supplementation alone may not improve hypokalemia in thyrotoxic hypokalemic periodic paralysis.
This article reports a 29-year-old man who came to the Emergency Department because of sudden onset of bilateral lower extremity weakness and inability to walk after intake of a high carbohydrate meal and alcohol. He was found to have severe hypokalemia, with K(+) level at 1.7 mmol/L. However, after administration of potassium chloride (KCl), 10 mEq/h intravenous (i.v.) drip for 4 h, follow-up serum potassium was even lower at 1.5 mmol/L and the patient complained of persistent weakness. Twenty mg of propranolol, a non-selective beta-blocker, was given orally and a dramatic improvement of muscle power to grade 5 was noted after 30 min of administration. On the fifth day after discharge, he had another episode of bilateral lower extremity weakness after ingesting a mouthful of alcohol. Muscle power recovered completely after i.v. drip of KCl, 20 mEq. Laboratory data revealed an underlying primary hyperthyroidism for which he was given anti-thyroid agents and beta-blockers.
Yu
Tsuan-Shih
TS
Division of Nephrology, Department of Medicine, Cardinal-Tien Hospital, School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan.
Tseng
Chin-Feng
CF
Chuang
Ying-Yen
YY
Yeung
Lai-King
LK
Lu
Kuo-Cheng
KC
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D004359:Drug Therapy, Combination; D006801:Humans; D020514:Hypokalemic Periodic Paralysis / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D011189:Potassium Chloride / Q000097:blood / Q000627:therapeutic use*; D011433:Propranolol / Q000627:therapeutic use; D013971:Thyrotoxicosis / Q000150:complications*
D000319:Adrenergic beta-Antagonists; D011189:Potassium Chloride; D011433:Propranolol