Thyrotoxic periodic paralysis with normokalemia: a rare case report

Authors

  • Pranav Ravi Kulkarni Department of Medicine, Saveetha Medical College Hospital, Tamil Nadu, India
  • Jagadeesan Mohanan Department of Medicine, Saveetha Medical College Hospital, Tamil Nadu, India
  • Mariraj I. Department of Medicine, Saveetha Medical College Hospital, Tamil Nadu, India
  • Prasanna Karthik Suthakaran Department of Medicine, Saveetha Medical College Hospital, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20212874

Keywords:

Periodic paralysis, Thyrotoxicosis, Normokalemia

Abstract

Thyrotoxic periodic paralysis (TPP) is a rare etiology for muscle paralysis. It is frequently seen in Asian men. Apart from paralysis, most of them are asymptomatic and are devoid of other clinical features of hyperthyroidism. Due to the rarity of this condition, it is often missed and hence fatal. The metabolic derangement seen in TPP is hypokalemia and is thought to be the pathogenesis of the muscle paralysis. Although in rare clinical encounters, patients with TPP may present with normokalemia. The disorder usually presents in the 3rd decade. The cause for mortality in patients with TPP may be due to respiratory muscle paralysis leading to compromise of the respiratory function or refractory arrhythmias due to hypokalemia. Here we report a rare case of TPP with normokalemia. 

References

Wu C, Wu, Lin J. Thyrotoxic periodic paralysis complicated by acute hypercapnic respiratory failure and ventricular tachycardia. Thyroid. 2008;18(12):1321-4.

Magsino CH, Jr, Ryan AJ, Jr. Thyrotoxic periodic paralysis. South Med J. 2000;93(10):996-1003.

Wu CC, Chau T, Chang CJ, Lin SH. An Unrecognized Cause of Paralysis in ED: Thyrotoxic Normokalemic Periodic Paralysis. Am J Emerg Med. 2003;21(1):71-3.

Kung AW. Clinical review: Thyrotoxic periodic paralysis: a diagnostic challenge. J Clin Endocrinol Metab. 2006;91(7):2490-5.

Tassone H, Moulin A, Henderson SO. The pitfalls of potassium replacement in thyrotoxic periodic paralysis: a case report and review of the literature. J Emerg Med. 2004;26(2):157-61.

Satam N, More V, Shanbag P, Kalgutkar A. Fatal thyrotoxic periodic paralysis with normokalemia. Indian J Pediatr. 2007;74(11):1041-3.

González-Treviño1 O, Rosas-Guzman J. Normokalemic thyrotoxic periodic paralysis: A new therapeutic strategy. Thyroid. 1999;9:61-3.

Lam L, Nair RJ, Tingle L. Thyrotoxic periodic paralysis. Proc (Bayl Univ Med Cent). 2006;19:126-9.

Rhee EP, Scott JA, Dighe AS. Case records of the Massachusetts General Hospital. Case 4-2012: A 37-year-old man with muscle pain, weakness, and weight loss. N Engl J Med. 2012;366:553-60.

Kufs WM, McBiles M, Jurney T. Familial thyrotoxic periodic paralysis West J Med. 1989;150:461-3.

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Published

2021-07-23

Issue

Section

Case Reports