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Hypokalemic thyrotoxic periodic paralysis: a case series

Published online by Cambridge University Press:  21 May 2015

Phillip Wong
Phillip Wong*
Affiliation:
Western Hospital, Melbourne, Australia

Abstract

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Hypokalemic periodic paralysis is a rare and dramatic complication of hyperthyroidism. This series summarizes the clinical and metabolic features of 10 patients who presented to the Western and Sunshine hospitals in Melbourne, Australia, between 1997 and 2002 with thyrotoxic periodic paralysis (TPP). TPP classically presents with proximal lower-limb weakness in the setting of a low potassium level and biochemical evidence of thyrotoxicosis: low thyroid-stimulating hormone levels along with elevated free thyroxine (FT4) or free triiodothyronine (FT3). The challenge for emergency physicians is to recognize the association with thyroid disease, since features of hyperthyroidism may not be apparent on history and examination. Acute treatment with potassium supplements and long-term management is aimed at achieving an euthyroid state. Thyrotoxic periodic paralysis is more common in Asian populations; however, increasing immigration from Asia will lead to higher TPP prevalence in Western countries.

Keywords

hypokalemic periodic paralysisthyrotoxicosisthyrotoxic periodic paralysis
Type
Case Report • Observations de cas
Information
Canadian Journal of Emergency Medicine , Volume 5 , Issue 5 , September 2003 , pp. 353 - 355
Copyright
Copyright © Canadian Association of Emergency Physicians 2003

References

1.Kelley, DE, Gharib, H, Kennedy, FP, Duda, RJ, McManis, PG. Thyrotoxic periodic paralysis: report of 10 cases and review of elec-tromyographic findings. Arch Intern Med 1989;149:2597–600.CrossRefGoogle ScholarPubMed
2.Manoukian, MA, Foote, JA, Crapo, LM. Clinical and metabolic features of thyrotoxic periodic paralysis in 24 episodes. Arch Intern Med 1999;159:601–6.Google Scholar
3.Yeo, PPB, Leo, KO, Cheah, JJ. Thyrotoxic periodic paralysis: a study of 51 patients. Proceedings of the Second Congress of the Association of Southeast Asian Nations (ASEAN) Federation of Endocrine Societies. Bangkok, Thailand; 1983.Google Scholar
4.Ober, KP. Thyrotoxic periodic paralysis in the United States: report of 7 cases, a review of the literature. Medicine 1992; 71:109–20.CrossRefGoogle Scholar
5.Goh, SH. Thyrotoxic periodic paralysis: reports of 7 patients presenting with weakness in an Asian emergency department. Emerg Med 2002;19:78–9.Google Scholar
6.Shizume, K, Shisiba, M, Sakuma, M, Yamauchi, H, Nakao, K, Okinaka, S. Studies of electrolyte metabolism in idiopathic and thyrotoxic periodic paralysis: total exchangeable sodium and potassium. Metabolism 1966;15:145–52.Google Scholar
7.Braverman, LE, Utiger, RD, editors. Werner and Ingbar’s The thyroid: a fundamental and clinical text. 8th ed. Lippincott Williams and Wilkins; 2000.Google Scholar
8.Conway, MJ, Seibel, JA, Eaton, RP. Thyrotoxic periodic paralysis: improvement with beta blockade. Ann Intern Med 1974; 81:332–6.CrossRefGoogle Scholar
9.Gandara, DR, Fariss, BL. Persistence of periodic paralysis following treatment of thyrotoxicosis: case report. Military Med 1979;144:337–8.CrossRefGoogle ScholarPubMed