Glucocorticoids may trigger attacks in several types of periodic paralysis.
Hypokalemic periodic paralysis is a rare disorder characterized by episodic attacks of muscle flaccidity associated with low serum potassium levels. We report twelve patients with normokalemic and hypokalemic periodic paralysis due to various mutations who developed hypokalemic paralytic episodes following a single dose or short-term administration of glucocorticoids. We hypothesize that glucocorticoids cause hypokalemia due to their stimulation of the Na(+)-K(+) ATPase mediated by insulin and amylin and due to their side effect of insulin resistance resulting in hyperglycemia. This report adds to the clinical description of glucocorticoids as a trigger of attacks of hypokalemic periodic paralysis indicating that glucocorticoids should be administered with caution in patients with periodic paralysis.
Arzel-Hézode
Marianne
M
Assistance Publique-Hôpitaux de Paris, Centre de Référence des Canalopathies Musculaires, Centre de Référence des Maladies Neuromusculaires-Paris Est et Service de Génétique, Groupe Hospitalier Pitié-Salpêtrière, 75651 Paris 13, France.
McGoey
Suzanne
S
Sternberg
Damien
D
Vicart
Savine
S
Eymard
Bruno
B
Fontaine
Bertrand
B
D000293:Adolescent; D000328:Adult; D000682:Amyloid / Q000378:metabolism; D004252:DNA Mutational Analysis; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005838:Genotype; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced / Q000378:metabolism / Q000503:physiopathology; D020514:Hypokalemic Periodic Paralysis / Q000139:chemically induced* / Q000235:genetics / Q000503:physiopathology*; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology; D000078790:Insulin Secretion; D007473:Ion Channels / Q000187:drug effects / Q000378:metabolism; D058228:Islet Amyloid Polypeptide; D008297:Male; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology*; D009154:Mutation / Q000235:genetics; D011188:Potassium / Q000032:analysis / Q000097:blood*; D012189:Retrospective Studies; D017678:Sex Distribution; D000254:Sodium-Potassium-Exchanging ATPase / Q000187:drug effects / Q000378:metabolism; D055815:Young Adult
D000682:Amyloid; D005938:Glucocorticoids; D007328:Insulin; D007473:Ion Channels; D058228:Islet Amyloid Polypeptide; D000254:Sodium-Potassium-Exchanging ATPase; D011188:Potassium