title: Thyrotoxic periodic paralysis in pregnancy with impaired glucose tolerance: a case report and discussion of management issues.
abstract: BACKGROUND
  Thyrotoxic periodic paralysis (TPP) is an unusual presentation of hyperthyroidism in women. The occurrence of this condition in the context of pregnancy is even more uncommon. Impaired glucose tolerance, pregnancy, and TPP impact overall management of thyrotoxicosis. There is little guidance in the literature for management under this constellation of circumstances.
  
  
  METHODS
  This is a case report of a previously healthy 36-year-old Filipino female presenting at 15 weeks gestation with tetraparesis, hypokalemia, and new onset Graves' disease with impaired glucose tolerance. Normal thyroid function was achieved in the mother without further episodes of TPP and a healthy, euthyroid male was delivered at 38 weeks gestation. Acute and long-term management strategies used in this case are described in detail.
  
  
  CONCLUSIONS
  A synthesis of the available literature allowed development of a practical management strategy applicable to a variety of situations involving TPP in pregnancy.
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, University of Calgary and the Calgary Health Region, Calgary, Alberta, Canada. loisdon@telus.net
authors.forename: Lois
authors.initials: L
authors.lastname: Donovan
authors.forename: Vicky M
authors.initials: VM
authors.lastname: Parkins
authors.forename: Aishling
authors.initials: A
authors.lastname: Mahalingham
mesh_terms: D000328:Adult; D005260:Female; D005951:Glucose Tolerance Test; D006111:Graves Disease / Q000150:complications* / Q000628:therapy*; D006801:Humans; D020514:Hypokalemic Periodic Paralysis / Q000209:etiology* / Q000628:therapy*; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology* / Q000628:therapy*; D011256:Pregnancy Outcome; D013971:Thyrotoxicosis / Q000150:complications* / Q000628:therapy*