title: Thyrotoxic periodic paralysis induced by pulse methylprednisolone.
abstract: We present a young Thai man who developed acute flaccid paralysis after receiving pulse methylprednisolone for chronic inflammatory demyelinating polyneuropathy. Hypokalemia from intracellular shift was confirmed by calculation of transtubular potassium gradient (TTKG). His muscle strength and serum potassium fully recovered with a small amount of potassium replacement. Graves' disease was subsequently diagnosed and treated with radioactive iodine. We suggest that acute paralysis after the use of steroids should raise a suspicion of thyrotoxic periodic paralysis (TPP). The potential mechanisms of steroid-induced TPP are discussed.
authors.affiliation: Division of Endocrine and Metabolism, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Somporn
authors.initials: S
authors.lastname: Wongraoprasert
authors.forename: Patinut
authors.initials: P
authors.lastname: Buranasupkajorn
authors.forename: Vitaya
authors.initials: V
authors.lastname: Sridama
authors.forename: Thiti
authors.initials: T
authors.lastname: Snabboon
mesh_terms: D000328:Adult; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006111:Graves Disease / Q000150:complications; D006801:Humans; D020514:Hypokalemic Periodic Paralysis / Q000139:chemically induced / Q000209:etiology*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D011115:Polyneuropathies / Q000188:drug therapy; D020551:Pulse Therapy, Drug; D013971:Thyrotoxicosis / Q000150:complications*