title: Hypokalemic paralysis in a young obese female.
abstract: BACKGROUND
  Profound hypokalemia with paralysis usually poses a diagnostic and therapeutic challenge.
  
  
  METHODS
  We report on a 28-y-old obese Chinese female presenting with sudden onset of flaccid quadriparesis upon awaking in the morning. There is no family history of hyperthyroidism. She experienced body weight loss of 7 kg in 2 months.
  
  
  RESULTS
  The most conspicuous blood biochemistry is marked hypokalemia (1.8 mmol/l) and hypophosphatemia (0.5 mmol/l) associated with low urine K(+) and phosphate excretion. Surreptitious laxatives and/or diuretics abuse-related hypokalemic paralysis were tentatively made. However, her relatively normal blood acid-base status and the absence of low urine Na(+) and/or Cl(-) excretion made these diagnoses unlikely. Furthermore, she developed rebound hyperkalemia (5.7 mmol/l) after only 80 mmol K(+) supplementation. Thyroid function test confirmed hyperthyroidism due to Graves' disease. Control of the hyperthyroidism completely abolished her periodic paralysis.
  
  
  CONCLUSIONS
  Thyrotoxic periodic paralysis (TPP) should be kept in mind as a cause of paralysis in female, even with obesity, despite its predominance in adult males.
authors.affiliation: Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Wen-Fang
authors.initials: WF
authors.lastname: Chiang
authors.forename: Yu-Juei
authors.initials: YJ
authors.lastname: Hsu
authors.forename: Chin-Chun
authors.initials: CC
authors.lastname: Chang
authors.forename: Shih-Hua
authors.initials: SH
authors.lastname: Lin
mesh_terms: D000328:Adult; D005260:Female; D006111:Graves Disease / Q000175:diagnosis; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced; D006980:Hyperthyroidism / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D007008:Hypokalemia / Q000097:blood / Q000175:diagnosis*; D020514:Hypokalemic Periodic Paralysis / Q000175:diagnosis / Q000188:drug therapy; D009765:Obesity / Q000150:complications; D010243:Paralysis / Q000150:complications / Q000209:etiology*; D011188:Potassium / Q000627:therapeutic use; D013960:Thyroid Function Tests
chemical_list: D011188:Potassium