Thyrotoxic hypokalemic periodic paralysis: case report and literature review

Medicina y Laboratorio

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Title Thyrotoxic hypokalemic periodic paralysis: case report and literature review
Parálisis periódica hipopotasémica tirotóxica: reporte de caso y revisión del tema
 
Creator Moreno-Rozo, Natalia Katherine
Rosero-Arellano, Carlos Hernán
García-Castaño, Sergio
 
Subject Paralysis, periodic paralysis, hypokalemia, thyrotoxicosis, thyroid hormones, hyperthyroidism.
parálisis, parálisis periódica, hipopotasemia, hipocalemia, tirotoxicosis, hormonas tiroideas, hipertiroidismo.
 
Description Abstract. Thyrotoxic hypokalemic periodic paralysis belongs to the primary periodic paralysis disorders, and presents as a complication of thyrotoxicosis. It is more common in male patients of Asian descent. It is characterized by recurrent episodes of sudden onset of limb weakness, associated with severe hypokalemia in a patient with underlying thyrotoxicosis. We present the case of a 32-year-old man, obese, who started his clinical manifestations with progressive weakness of the lower and upper limbs, which limited walking almost entirely. He referred having presented the same clinical manifestations a few months ago, with spontaneous improvement. Paraclinical tests showed hypokalemia 1,6 mmol/L, and a biochemical profile of thyrotoxicosis with suppressed TSH, and elevated T3 and T4, positive anti-peroxidase antibodies, and thyroid scintigraphy with diffuse goiter, confirming the thyrotoxic hypokalemia periodic paralysis diagnosis, associated with Graves’ disease. Hypokalemia was rapidly corrected with an intravenous infusion of potassium, with clinical improvement. Hyperthyroidism was managed with beta-blockers, thionamides, and subsequently with radioactive iodine.
 
La parálisis periódica hipopotasémica tirotóxica, también conocida como parálisis periódica hipocalémica tirotóxica, forma parte de las parálisis periódicas primarias, y se presenta como complicación de la tirotoxicosis. Es más común en pacientes de sexo masculino y en asiáticos. Se caracteriza por episodios recurrentes de debilidad de extremidades de inicio súbito, asociados a hipopotasemia grave en un paciente con tirotoxicosis de base. Se presenta el caso de un hombre de 32 años, con obesidad, quien refiere haber presentado por varios meses episodios recurrentes de debilidad progresiva en miembros inferiores y superiores que limitaban la marcha, con mejoría espontánea. Como paraclínicos se reportaron hipopotasemia severa de 1,6 mmol/L, y un perfil bioquímico de tirotoxicosis con TSH suprimida, T3 y T4 elevadas, anticuerpos antiperoxidasa positivos y gammagrafía de tiroides con bocio difuso hipercaptante, que confirmaron el diagnóstico de una parálisis periódica hipopotasémica tirotóxica, asociada a una enfermedad de Graves. La hipopotasemia se corrigió rápidamente con la infusión de potasio intravenoso, con mejoría clínica de la debilidad. El hipertiroidismo se manejó con beta-bloqueadores, tionamidas y posteriormente con yodo radioactivo.
 
Publisher EDIMECO S.A.
 
Date 2020-06-30
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
 
Format application/pdf
 
Identifier https://medicinaylaboratorio.com/index.php/myl/article/view/301
10.36384/01232576.301
 
Source Medicina & Laboratorio; Vol. 24 No. 3 (2020); 245-254
Medicina y Laboratorio; Vol. 24 Núm. 3 (2020); 245-254
2500-7106
0123-2576
 
Language spa
 
Relation https://medicinaylaboratorio.com/index.php/myl/article/view/301/293
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