title: Case of thyrotoxic periodic paralysis in a caucasian male and review of literature.
abstract: Objective. Thyrotoxic periodic paralysis (TPP), a known condition in Asian men, is becoming increasingly common in men from Western countries. Since suspicion for TPP as a differential in diagnosis is of utmost importance to avoid overcorrection of hypokalemia and other complications, we are reporting a case of TPP in a 25-year-old Caucasian male. Methods. The patient presented with intermittent lower extremity weakness after consumption of a large high-carbohydrate meal. Clinical examination revealed diffusely enlarged thyroid gland, no muscle power in lower extremities, tremors, and brisk deep tendon reflexes. Results. Clinical and laboratory findings were consistent with Graves' disease and the patient had hypokalemia. The patient responded to potassium repletion and was treated with propylthiouracil and propranolol. After treatment with radioactive iodine, the patient developed postablative hypothyroidism for which he was treated with levothyroxine. Conclusion. Since this condition is overlooked by physicians in Western countries, we present a case of TPP in a Caucasian male thus showing the importance of consideration of TPP in Caucasians despite its rare occurrence and the need for prompt diagnosis to avoid the danger of hyperkalemia in management of the paralytic attack in TPP patients.
authors.affiliation: Section of Endocrinology, Tulane University Health Sciences Center, 1430 Tulane Avenue, SL-53, New Orleans, LA 70112, USA ; Southeast Louisiana Veterans Health Care Systems, New Orleans, LA 70112, USA.
authors.forename: Tina K
authors.identifier: 0000-0001-6140-906X
authors.initials: TK
authors.lastname: Thethi
authors.affiliation: Southeast Georgia Department of Health, Waycross, LA 31501, USA.
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Parks
authors.affiliation: Tulane University Health Sciences Center, New Orleans, LA 70112, USA.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Katalenich
authors.affiliation: Sanofi Pasteur India Ltd, Mumbai 400093, India.
authors.forename: Pankdeep
authors.identifier: 0000-0002-9389-2479
authors.initials: P
authors.lastname: Chhabra
authors.affiliation: Tulane University Health Sciences Center, New Orleans, LA 70112, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: McCaw
authors.affiliation: Tulane University Health Sciences Center, New Orleans, LA 70112, USA.
authors.forename: Stephanie
authors.identifier: 0000-0002-5996-3296
authors.initials: S
authors.lastname: Syu
authors.affiliation: Tulane University Health Sciences Center, New Orleans, LA 70112, USA.
authors.forename: Tuyen
authors.initials: T
authors.lastname: Nguyen
authors.affiliation: University of New Orleans, New Orleans, LA 70148, USA.
authors.forename: Joshua
authors.identifier: 0000-0001-5397-8553
authors.initials: J
authors.lastname: Larrazolo
authors.affiliation: Tulane University Health Sciences Center, New Orleans, LA 70112, USA.
authors.forename: Kartik
authors.identifier: 0000-0002-0890-064X
authors.initials: K
authors.lastname: Munshi
authors.affiliation: Tulane University Health Sciences Center, New Orleans, LA 70112, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Waddadar
authors.affiliation: St. Joseph Mercy Oakland, Pontiac, MI 48341, USA.
authors.forename: Prathima
authors.initials: P
authors.lastname: Nagireddy