Thyrotoxic Periodic Paralysis Associated with Transient Thyrotoxicosis Due to Painless Thyroiditis

Abstract

Thyrotoxic periodic paralysis (TPP) is a rare manifestation of hyperthyroidism characterized by muscle weakness and hypokalemia. All ethnicities can be affected, but TPP typically presents in men of Asian descent. The most common cause of TPP in thyrotoxicosis is Graves' disease. However, TPP can occur with any form of thyrotoxicosis. Up to our knowledge, very few cases ever reported the relationship between TPP and painless thyroiditis. We herein report a 25-yr-old Korean man who suffered from flaccid paralysis of the lower extremities and numbness of hands. The patient was subsequently diagnosed as having TPP associated with transient thyrotoxicosis due to painless thyroiditis. The paralytic attack did not recur after improving the thyroid function. Therefore, it is necessary that early diagnosis of TPP due to transient thyrotoxicosis is made to administer definite treatment and prevent recurrent paralysis.

Severe Hypokalemia and Thyrotoxic Paralysis from Painless Thyroiditis Complicated by Life-threatening Polymorphic Ventricular Tachycardia and Rhabdomyolysis

“…Only two patients with thyrotoxic periodic paralysis due to a painless thyroiditis have been reported (2,3). There are a few descriptions of fatal ventricular arrhythmias in patients with thyrotoxicosis due to Graves' disease, but only one case with painless thyroiditis has been published (2).…”

Thyrotoxic periodic paralysis complicated by life-threatening acute hypercapnic respiratory failure in a Chinese male with painless thyroiditis

“…In this case, based on the patient's clinical presentation and associated findings, a diagnosis of TPP due to painless thyroiditis was made. Painless thyroiditis presenting with TPP has been rarely reported [7][8][9][10][11]. A literature review revealed only 8 cases of TPP due to painless thyroiditis including our case ( Table 1).…”

Thyrotoxic hypokalemic periodic paralysis due to Graves’ disease in 2 adolescents

“…TPP is the most frequent form of acquired muscle paralysis in young adults [6]. The ratio of cases in males to females ranges from 17:1 to 70:1 [7].…”

“…The most common cause of TPP is Graves' disease. However, TPP can occur in any type of thyrotoxicosis [6]. In general, autoimmune thyroid diseases such as Graves’ disease are more common in pubertal girls than boys.…”