3-24-05 Thyrotoxic periodic paralysis in Caucasians. Report of 8 cases

Reisin, Ricardo; Martínez, Óscar; Moran, Martin J.; Rovira, M; Pardal, Ana; Rocatagliata, Guillermo; Balze, E. de la

doi:10.1016/s0022-510x(97)85716-4

Cited by 5 publications

(13 citation statements)

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“…1,2 The disease has also been reported in Hispanics 4 and Caucasians. 1 The disease affects 2% of Asians and 0.1% to 0.2% 3,5 of non-Asians with hyperthyroidism. One study by Reisin and colleagues 1 reviewed the reported cases of TPP in the United States.…”

Section: Reviewmentioning

confidence: 91%

“…Other reported etiologies of thyrotoxicosis include thyroid adenomas, pituitary adenomas, lymphocytic thyroiditis, and iodine-induced and iatrogenic thyrotoxicosis. 3 Often the symptoms are mild or absent 1,3,4 with the thyroid gland having a normal or enlarged size.…”

Section: Reviewmentioning

confidence: 99%

“…On average, the patient will experience 2.8 episodes before the diagnosis is made. 1 The severity of the symptoms tend to decrease with age.…”

Section: Reviewmentioning

confidence: 99%

“…3 They can be precipitated by strenuous exercise, high carbohydrate meals, trauma, cold, alcohol, infection, emotional stress, and administration of insulin. [1][2][3][6][7][8] The attacks tend to occur in the early morning, 1,4 with the majority of the attacks occurring between 9 AM and 9 PM. 7 Barnabe 2 reported that 84% of the episodes occurred between 1 AM and 6 AM.…”

Section: Reviewmentioning

confidence: 99%

“…1,2 The disease shows a marked male predominance 2,3 and is characterized by periodic episodes of paralysis and weakness. The authors present a rare case of a fatal cardiac dysrhythmia secondary to the disease.…”

mentioning

confidence: 99%

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Fatal Dysrhythmia Secondary to Thyrotoxicosis Periodic Paralysis in a 24-Year-Old White Male

Wreford¹,

Lambourne

2007

Lab Med

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Thyrotoxicosis hypokalemic periodic paralysis is a rare autosomal recessive condition most commonly seen in Asian populations. 1,2 The disease shows a marked male predominance 2,3 and is characterized by periodic episodes of paralysis and weakness. The authors present a rare case of a fatal cardiac dysrhythmia secondary to the disease. Case PresentationA 24-year-old white male presented to the emergency department with acute weakness of the legs. Upon waking, the patient was unable to move his legs, although he noted no sensory loss to the legs. He stated that he had mild weakness with some cramping of the legs for 1 week prior without sensory decrease. The cramping was particularly noticeable at rest. The patient also complained of weakness of the left arm and an inability to void urine.A review of the patient's clinical history showed a similar episode a year previous to the current episode. At that time, the episode lasted 2 to 3 days and resolved spontaneously. A family relative, who was a physician, made a diagnosis of dehydration. It was suggested that the patient try Pedialyte or bananas to relieve the symptoms. At this point, the patient began eating 2 bananas per day.The patient also reported occasional blurring of his vision. No loss of memory or consciousness was noted. The patient had no history of seizures. A history of hyperthyroidism, hypertension, and a possible herniated disc 6-years previously were noted. The herniated disc was treated and resolved with a cortisone injection. The patient's family and social history were negative for drug use and smoking. The patient had a recent travel history to Colorado for 3 months from which the patient had returned 2 weeks prior to presentation.On physical examination, the patient was a well-developed and well-nourished white male who was alert and anxious. The patient's blood pressure was 134/69 with a pulse of 150. The patient's temperature was 97.9°F. The patient's respirations were 28/min. His thyroid was reported as palpably enlarged.While a neurologic examination of the patient showed flaccid lower extremities with an absence of ankle and knee reflexes, the patient retained sensation within the affected limbs. After 3 hours, the patient's leg strength had significantly improved and his deeptendon reflects had returned. The patient was alert and fully oriented, there was no alteration of speech, and the patient followed commands without difficulty. The patient's pupils were equal round and reactive to light. No nystagmus or alteration in extraocular movements was noted. No facial asymmetry was noted.Initial laboratory values in the emergency department were as follows: potassium = 2.9 mM/L, sodium = 140 mM/L, total CO 2 = 25 mM/L, serum glucose = 122 mg/dL, ESR = 15 mm/hour, TSH = 0.05 uIU/mL, WBC = 9.0 K/uL with a normal differential count, Hct = 42.5%, Hgb = 13.9g/dL, MCV = 78 fL, PLT = 229 K/dL.Magnetic resonance images (MRIs) of the cervical and thoracic spine were performed, with and without contrast. These showed a small left paramedial disc her...

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Section: Reviewmentioning

confidence: 91%

Section: Reviewmentioning

confidence: 99%

“…On average, the patient will experience 2.8 episodes before the diagnosis is made. 1 The severity of the symptoms tend to decrease with age.…”

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

mentioning

confidence: 99%

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Fatal Dysrhythmia Secondary to Thyrotoxicosis Periodic Paralysis in a 24-Year-Old White Male

Wreford¹,

Lambourne

2007

Lab Med

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Thyrotoxic Periodic Paralysis: Case Reports and an Up-to-Date Review of the Literature

Lulsegged

Wlodek

Rossi

2011

Case Reports in Endocrinology

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Objectives. To describe 2 cases of thyrotoxic periodic paralysis. Methods. We report of 2 cases of thyrotoxic periodic paralysis in 2 individuals from 2 different backgrounds with emphasis on their presentation and treatment. We also conducted a literature search to put together an update review of thyrotoxic periodic paralysis. Results. A 47-year-old Chinese and 28-year-old Caucasian male presented with profound yet reversible weakness associated with hypokalemia on admission bloods and thyrotoxicosis. Both were given definitive therapy to prevent recurrence of attacks with any future relapse of thyrotoxicosis. Conclusion. Thyrotoxic periodic paralysis (TPP) is a rare but potentially serious complication of thyrotoxicosis resulting in temporary but severe muscle weakness. Recent discovery of a novel mutation in the KCNJ18 gene which codes for an inwardly rectifying potassium channel and is controlled by thyroid hormones may provide greater insight into the pathogenesis of TPP.

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Thyrotoxic periodic paralysis in an Italian man: clinical manifestation and genetic analysis

et al. 2008

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In Western countries, thyrotoxic periodic paralysis (TPP) is a rare condition with only sporadic cases described so far. Here, we describe a 29-year-old Italian man who presented with leg weakness and hypokalaemia. Treatment with intravenous potassium resulted in a rapid resolution of symptoms. TPP as the underlying cause was suggested by suppressed thyroid-stimulating hormone (TSH), elevated free T3 and free T4, and the presence of TSH-receptor antibodies (TRAB). Genetic analysis showed no mutations in the candidate exons of calcium (CACN1AS), potassium (KCNE3) and sodium (SCN4A) channel genes. However, we identified the presence of two single nucleotide polymorphisms (SNPs), 1491C > T and 1551 T > C, in exon 11 of the CACN1AS gene. Although the 1491C > T SNP is not apparently involved in the pathogenesis of the disease, the 1551 T > C SNP has been associated with TPP in Asians and reported in only one case in European Caucasians. Further investigations are needed to clarify whether such polymorphisms have a role in the disease pathogenesis in Caucasians.

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3-24-05 Thyrotoxic periodic paralysis in Caucasians. Report of 8 cases

Cited by 5 publications

References 0 publications

Fatal Dysrhythmia Secondary to Thyrotoxicosis Periodic Paralysis in a 24-Year-Old White Male

Fatal Dysrhythmia Secondary to Thyrotoxicosis Periodic Paralysis in a 24-Year-Old White Male

Thyrotoxic Periodic Paralysis: Case Reports and an Up-to-Date Review of the Literature

Thyrotoxic periodic paralysis in an Italian man: clinical manifestation and genetic analysis

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