title: Thyrotoxic hypokalaemic periodic paralysis in a Turkish population: three new case reports and analysis of the case series.
abstract: OBJECTIVE
  Thyrotoxic hypokalaemic periodic paralysis (THPP) is an uncommon condition with intermittent episodes of muscle weakness and occasionally severe paralysis. THPP is a common complication of hyperthyroidism in Asian populations, and has also been reported in other ethnic groups including Caucasians. This study aimed to conduct an analysis of THPP in a Turkish population, and is to our knowledge the first analysis of a homogeneous Caucasian group.
  
  
  METHODS
  Forty cases with THPP were identified in the Turkish population. Three out of the 40 were new cases and were assigned as index cases. Two cases were not included in the analysis because of lack of data.
  
  
  RESULTS
  THPP was diagnosed in 10 cases during the first attack and was observed to have a significant shorter complete recovery time statistically in this group (P < 0.01). The majority of cases were hypokalaemic, while there were two normokalaemic cases. Classification of the cases according to their potassium (K) levels revealed that the group with K levels < 2.5 mEq/l had a statistically longer amelioration time than the group with K levels > or = 2.5 mEq/l. When the cases were classified according to intravenous or oral application of K, the mean amelioration time was 6.8 +/- 3.6 h for the intravenous group and 13.1 +/- 7.6 for the oral group. Mean complete recovery times of the groups were 29.4 +/- 16.2 h and 52.8 +/- 18.0 h, respectively. The intravenous group had a shorter amelioration time and complete recovery time, and both were statistically significant (P < 0.05 for each).
  
  
  CONCLUSIONS
  THPP may be seen among Caucasians. Diagnosing THPP during the first attack might decrease the recovery time. The level of hypokalaemia seems to affect the recovery time and initial low K levels may lead to more deterioration in a patient's health compared with mild or near-normal levels. Intravenous, rather than oral, application of K may be advantageous for shortening both the amelioration and complete recovery times.
authors: Ufuk University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey. drcesur@ttnet.net.tr
authors: Mustafa
authors: M
authors: Cesur
authors: Fahri
authors: F
authors: Bayram
authors: Mehtap Akcil
authors: MA
authors: Temel
authors: Mesut
authors: M
authors: Ozkaya
authors: Abdulkadir
authors: A
authors: Kocer
authors: Melek Eda
authors: ME
authors: Ertorer
authors: Filiz
authors: F
authors: Koc
authors: Ahmet
authors: A
authors: Kaya
authors: Sevim
authors: S
authors: Gullu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D020514:Hypokalemic Periodic Paralysis / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult