Thyrotoxic periodic paralysis. A case report.
Thyrotoxic hypokalemic periodic paralysis (TPP)--a rare complication of thyrotoxicosis and a medical emergency--is characterized by recurrent episodes of muscle weakness and hypokalemia associated with hyperthyroidism. We report a case of TPP in a 38-year-old white Lebanese male. The patient suffered from severe muscle weakness of the upper and lower limbs. His blood tests revealed hypokalemia (k: 2.4 mEq/L), low thyroid-stimulating hormone TSH (0.001 microIU/mL) and normal levels of thyroid hormones. The thyroid scan showed a hot nodule. His paralysis resolved with IV potassium. The patient was treated with propranolol and radioactive iodine with complete remission of the hyperthyroidism and the paralysis. A discussion of the clinical and pathophysiological features and treatment of TPP is presented.
Atallah
Paola
P
Department of Endocrinology, Saint George Hospital University Medical Center, Affiliated to the University of Balamand, Faculty of Medicine & Medical Sciences, Division of Endocrinology and Neurology, Beirut, Lebanon. paolaatt@hotmail.com
Dib
Elie R
ER
Khoury
Mounir
M
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications / Q000000981:diagnostic imaging; D007008:Hypokalemia / Q000209:etiology; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D018908:Muscle Weakness / Q000209:etiology; D010243:Paralysis / Q000209:etiology*; D011188:Potassium / Q000627:therapeutic use; D011433:Propranolol / Q000627:therapeutic use; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D016606:Thyroid Nodule / Q000150:complications / Q000000981:diagnostic imaging; D013971:Thyrotoxicosis / Q000150:complications* / Q000000981:diagnostic imaging; D013972:Thyrotropin / Q000097:blood
D000319:Adrenergic beta-Antagonists; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D013972:Thyrotropin; D011433:Propranolol; D011188:Potassium