A case of thyrotoxic periodic paralysis with respiratory failure in an African American woman.
Thyrotoxic periodic paralysis is an acute endocrine emergency characterized by hyperthyroidism, profound muscle weakness and/or paralysis, and hypokalemia that is not due to potassium deficiency. Typically described in young males of Asian descent, it is becoming increasingly recognized outside of this demographic group and is believed to be an underrecognized cause of symptomatic hypokalemia. Thyrotoxic periodic paralysis usually manifests as acute onset of symmetrical distal extremity weakness and is treated with careful potassium replacement and nonselective β-blockers. In this case, a 43-year-old African American woman with thyrotoxic periodic paralysis had recurrent lower extremity myopathy and acute respiratory failure precipitated by noncompliance with treatment for Graves disease.
Denise L. Shields is an acute care nurse practitioner at Robert Wood Johnson University Hospital, Hamilton Township, New Jersey. DeniseShields@verizon.net.
Denise L
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Shields
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D001741:Black or African American; D013956:Antithyroid Agents / Q000627:therapeutic use; D005260:Female; D006111:Graves Disease / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications / Q000188:drug therapy; D007008:Hypokalemia / Q000150:complications / Q000188:drug therapy; D008713:Methimazole / Q000627:therapeutic use; D018908:Muscle Weakness / Q000150:complications* / Q000188:drug therapy; D010243:Paralysis / Q000150:complications* / Q000188:drug therapy; D011188:Potassium / Q000627:therapeutic use; D011433:Propranolol / Q000627:therapeutic use; D012131:Respiratory Insufficiency / Q000150:complications* / Q000188:drug therapy
D000319:Adrenergic beta-Antagonists; D013956:Antithyroid Agents; D008713:Methimazole; D011433:Propranolol; D011188:Potassium