title: Hypokalemic Paralysis Complicated by Concurrent Hyperthyroidism and Chronic Alcoholism: A Case Report.
abstract: Thyrotoxic periodic paralysis (TPP) is characterized by the presence of muscle paralysis, hypokalemia, and hyperthyroidism. We report the case of a young man with paralysis of the lower extremities, severe hypokalemia, and concurrent hyperthyroidism. TPP was suspected; therefore, treatment consisting of judicious potassium (K+) repletion and β-blocker administration was initiated. However, urinary K+ excretion rate, as well as refractoriness to treatment, was inconsistent with TPP. Chronic alcoholism was considered as an alternative cause of hypokalemia, and serum K+ was restored through vigorous K repletion and the addition of K+ -sparing diuretics. The presence of thyrotoxicosis and hypokalemia does not always indicate a diagnosis of TPP. Exclusion of TPP can be accomplished by immediate evaluation of urinary K+ excretion, acid-base status, and the amount of potassium chloride required to correct hypokalemia at presentation.
authors.affiliation: From the Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital (MHT, JGL, YWF); and Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (SHL).
authors.forename: Ming-Hsien
authors.initials: MH
authors.lastname: Tsai
authors.forename: Shih-Hua
authors.initials: SH
authors.lastname: Lin
authors.forename: Jyh-Gang
authors.initials: JG
authors.lastname: Leu
authors.forename: Yu-Wei
authors.initials: YW
authors.lastname: Fang
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000175:diagnosis; D002908:Chronic Disease; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications* / Q000175:diagnosis; D020514:Hypokalemic Periodic Paralysis / Q000150:complications* / Q000175:diagnosis*; D008297:Male