Thyrotoxic periodic paralysis is a potentially life-threatening condition associated with recurrent episodes of muscle weakness and hypokalaemia due to hyperthyroidism. Diagnosis is often delayed or misdiagnosed due to its rarity in the western world and subtle features of hyperthyroidism on initial presentation. Here we present the case of a 25-year-old man who presented to the emergency department (ED) with sudden onset weakness of bilateral upper and lower extremities. His labs revealed hypokalaemia with elevated T4 and suppressed thyroid-stimulating hormone and he was diagnosed with thyrotoxic periodic paralysis. He was treated with potassium repletion, atenolol and methimazole with complete reversal of his paralysis within the next day. Unfortunately, he failed to keep the follow-up appointment after discharge, ran out of his methimazole and landed up in the ED again.
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http://dx.doi.org/10.1136/bcr-2016-218951 | DOI Listing |
Introduction: Thyrotoxic hypokalemic periodic paralysis (THPP) is a rare but severe complication of hyperthyroidism characterized by acute muscle weakness. This study reports the first case of THPP in an adolescent with type 1 diabetes mellitus (T1DM) and Graves' disease, triggered by high-dose insulin, high carbohydrate intake, and strenuous exercise. It highlights the clinical presentation, management, and implications of THPP in this context.
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November 2024
Emergency Medicine, Mayo Clinic Arizona, Phoenix, USA.
Thyrotoxic periodic paralysis (TPP) is a rare but significant complication of hyperthyroidism, characterized by episodes of muscle weakness or paralysis and associated hypokalemia. This case report details a 30-year-old Latin American male with a history of Graves' disease, presenting with acute muscle weakness and hypokalemia. The patient reported transient episodes of weakness over recent weeks, culminating in a severe episode prompting emergency evaluation.
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November 2024
Emergency Medicine, Amrita Institute of Medical Sciences, Kochi, IND.
One type of hypokalemic periodic paralysis that is associated with hyperthyroidism is called thyrotoxic periodic paralysis (TPP). TPP can be linked to any cause of hyperthyroidism, although Graves' disease is the most common cause. This sporadic variant of hypokalaemic periodic paralysis, thyrotoxic periodic paralysis, is characterized by rapid onset weakness in the proximal muscles.
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November 2024
Internal Medicine Department, Saint Joseph Hospital, Jerusalem, PSE.
Thyrotoxic periodic paralysis (TPP) is a rare complication primarily associated with thyrotoxicosis, particularly in individuals with Graves' disease. While more common in males aged 20 to 40, it can occur across all ethnic backgrounds. It is the most common type of acquired periodic paralysis.
View Article and Find Full Text PDFMedicina (Kaunas)
October 2024
Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania.
Hypokalemia is a common laboratory finding in hospitalized patients, typically resulting from insufficient potassium intake, renal or gastrointestinal losses, or intracellular shifts. While the underlying cause is often easily identifiable, certain cases present diagnostic challenges, and if left unrecognized, the consequences can be life-threatening. We report a rare and atypical case of severe symptomatic hypokalemia as the initial presentation of newly diagnosed Graves' disease.
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