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.
Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India.
Nitin
N
Satam
Vaishali
V
More
Preeti
P
Shanbag
Alka
A
Kalgutkar
D002648:Child; D005260:Female; D006801:Humans; D010245:Paralyses, Familial Periodic / Q000097:blood / Q000150:complications*; D012131:Respiratory Insufficiency / Q000150:complications*; D013971:Thyrotoxicosis / Q000150:complications*