Fatal thyrotoxic periodic paralysis with normokalemia.
We present a 10-year-old girl who presented to our emergency services with difficulty in breathing of 2-days duration and progressive weakness of a month's duration. In a previous admission elsewhere, she had not been detected to have hyperthyroidism or electrolyte abnormalities. On admission, the child was in hypercapnic respiratory failure with tachycardia and hepatomegaly. A small goiter as well as signs of thyrotoxicosis were present. Laboratory investigations showed anemia, mildly elevated liver enzymes and serum potassium of 4.8mEq/L. Despite intubation and ventilation and other supportive management including propranolol, the patient could not be saved. Post-mortem biopsy of the thyroid showed diffuse hyperplasia of the follicles and muscles showed evidence of thyroid myopathy.
Satam
Nitin
N
Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India.
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Vaishali
V
Shanbag
Preeti
P
Kalgutkar
Alka
A
D002648:Child; D005260:Female; D006801:Humans; D010245:Paralyses, Familial Periodic / Q000097:blood / Q000150:complications*; D012131:Respiratory Insufficiency / Q000150:complications*; D013971:Thyrotoxicosis / Q000150:complications*