Thyrotoxic periodic paralysis as the first manifestation of a thyrotropin-secreting pituitary adenoma

Παππά, Θεοδώρα; Papanastasiou, Labrini; Markou, Αthina; Androulakis, Ioannis I.; Kontogeorgos, George; Seretis, Andreas; Piaditis, George

doi:10.14310/horm.2002.1257

Cited by 12 publications

(6 citation statements)

References 31 publications

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“…This is a very rare case of THPP in the uncommon setting of secondary hyperthyroidism due to a TSH secreting adenoma9 10 together with a hyperfunctioning pituitary gonadotropic tumour secreting FSH and LH. The resulting stimulation of the gonads produces increased testosterone and inhibin.…”

Section: Discussionmentioning

confidence: 92%

Pituitary macroadenoma: a rare cause of thyrotoxic hypokalaemic periodic paralysis

et al. 2013

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Thyrotoxic hypokalaemic periodic palsy (THPP) is a well-recognised but under-diagnosed complication of hyperthyroidism and is commonly seen in Asian males. Patients usually present fully conscious with acute onset of severe motor weakness. Baseline investigation reveals severe hypokalaemia due to Na(+)/K(+) ATPase overactivity causing a massive influx of intracellular potassium ions. The most common cause of THPP identified in the medical literature is Graves' disease. We report an interesting and unusual case of THPP due to previously undiagnosed hyperthyroidism secondary to a pituitary macroadenoma. The patient was consequently found to have a tumour secreting gonadotropin and thyrotropin.

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Section: Discussionmentioning

confidence: 92%

Pituitary macroadenoma: a rare cause of thyrotoxic hypokalaemic periodic paralysis

et al. 2013

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“…The serum thyroid-stimulating hormone level is low or suppressed accompanied by raised free thyroxine (fT4) and triiodothyronine (fT3) levels consistent with primary thyrotoxicosis. Rarely some patients may have central thyrotoxicosis in which case the TSH is detectable and associated with elevated fT4 and fT3 levels [23]. Milder forms of thyrotoxicosis have been associated with thyrotoxic periodic paralysis adding to the diagnostic difficulties [24].…”

Section: Discussionmentioning

confidence: 99%

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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“…8 TPP is more prevalent among Asian descents, incidence of TPP in Chinese and Japanese thyrotoxic patients has been reported at 1.8% and 1.9% respectively. 9 TPP has also been reported in young Hispanics, white and native American but actual incidence and prevalence rates are unknown as the literature consists of only case series and case reports. 10,11 TPP should not be excluded from the differential diagnosis of paralysis solely because of the ethnicity of the patient.…”

Section: Epidemiologymentioning

confidence: 99%

“…[13][14][15][16][17] Graves' disease is the most common etiology however TPP has also been reported in patients taking exogenous thyroid supplementation such as weight loss products and herbal medicines containing triiodothyronine (T3) and from thyrotropin-secreting pituitary adenomas. 9,11,18,19 Clinical presentation Hypokalemic paralysis, commonly observed in patients presenting to the emergency department, may be caused by neurologic, metabolic, or renal disorders. 11 In the case of TPP the classic triad of flaccid paralysis, signs of thyrotoxicosis and hypokalemia during a paretic crisis is the cornerstone for diagnosis.…”

Section: Pathogenesismentioning

confidence: 99%

Parálisis Periódica Hipopotasémica Tirotóxica, Una Emergencia Neuroendocrina: Artículo de Revisión.

Arosemena¹,

Balda²,

Sanchez-Armijos³

2020

revecuatneurol

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La parálisis periódica tirotóxica (PPT) es una emergencia neuroendocrina y, aunque es poco común, debe estar en el diagnóstico diferencial de debilidad en un paciente con hipertiroidismo. Usualmente, se desencadena por una dieta alta en carbohidratos, trauma, exposición al frío o ejercicio extenuante. La mayoría de los casos se presentan en varones asiáticos de 20 a 30 años. El diagnóstico es clínico con la triada de parálisis flácida, signos de tirotoxicosis e hipopotasemia. El tratamiento consiste en reposición de electrolitos, tionamidas y beta bloqueantes. La importancia de reconocer la asociación entre el hipertiroidismo y la parálisis hipopotasémica es vital, ya que el tratamiento e xitoso del hipertiroidismo resuelve la parálisis.

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Thyrotoxic periodic paralysis as the first manifestation of a thyrotropin-secreting pituitary adenoma

Cited by 12 publications

References 31 publications

Pituitary macroadenoma: a rare cause of thyrotoxic hypokalaemic periodic paralysis

Pituitary macroadenoma: a rare cause of thyrotoxic hypokalaemic periodic paralysis

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

Parálisis Periódica Hipopotasémica Tirotóxica, Una Emergencia Neuroendocrina: Artículo de Revisión.

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