Thyrotoxic Periodic Paralysis Crosses Boarders From Muscles to the Heart: A Case of Hypokalemic Ventricular Tachycardia

Ghalyoun, Bader Abu; Khaddash, Ibrahim; Mourad, Ismail; Shamoon, Dema; Linaac, Allarice; Tiyyagura, Satish

doi:10.1016/s0735-1097(19)32929-8

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“…9 In another case, the presence of TPP with ventricular tachycardia. 15 The presence of arrhythmias, in this case, can be associated with the occurrence of hypokalemia within a certain time. Low potassium in the extracellular can compensate the body to increase Na channel activity and a buildup of Na in the intracell.…”

Section: Discussionmentioning

confidence: 97%

Sudden weakness due to thyrotoxic periodic paralysis: a case report

2022

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Thyrotoxic periodic paralysis (TPP) is a complication of hyperthyroidism. Lead to sudden hypokalemia and muscle weakness. In most cases, it is found mainly in young adult males of the Asian race. The paralysis is temporary and will return with potassium correction. There are very few cases reported in Indonesia regarding these cases of TPP. In our case, a 44-year old man complained of weakness that started later in the limbs but quickly improved. This case was diagnosed late at first, and uncorrected potassium levels led to recurrent paralysis. Laboratory test results showed severe hypokalemia (potassium level 1.81 mmol/L). The thyroxine level (T4) was 44.12 pmol/L and low serum thyroid-stimulating hormone (TSH) <0.0025 IU/mL.

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Section: Discussionmentioning

confidence: 97%

Sudden weakness due to thyrotoxic periodic paralysis: a case report

2022

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“…В этих случаях ВГМ дебютировали типичными клиническими проявлениями [16], однако необычным оказалось отсроченное появление признаков тиреотоксикоза по сравнению с ранней манифестацией миоплегических нарушений, что затрудняло проведение дифференциальной диагностики. После хирургического лечения, при устранении этиологического фактора, как и в сообщениях других авторов [7], отмечался полный регресс ВГМ без сердечно-сосудистых осложнений, присущих ВГМ при тиреотоксикозе [17].…”

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Secondary hypokalemic myoplegias

Саковец

Богданов

2019

RJTAO

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Objective: to investigate the features of clinical manifestations and course of secondary hypokalemic myoplegia (SHM) of various etiologies.Patients and methods. The investigation enrolled 10 patients with SHM. The patients' mean age was 39.5±16.2 years. The cause of SHM was hyperaldosteronism in 3 cases, thyrotoxicosis in 1, nontraumatic rhabdomyolysis in 2, and severe toxicosis and massive obstetric hemorrhage in 4.Results and discussion. The blood potassium level difference between days 7 and 1 of hospitalization in patients with hyperaldosteronism and thyrotoxicosis was 2.2±0.4 mmol/l; this indicator in the other patients was less (1.6±0.8 mmol/l). The dynamics of an increase in the blood potassium concentrations during the 7 days differed significantly in 4 pregnant women who had undergone a cesarean section for placental abruption, antenatal fetal death, or their severe toxicosis with suddenly developed neuromuscular disorders (2.1±0.8 mmol/l), and in other patients with SHM (1.4±0.2 mmol/l). SHM in Conn's syndrome and thyrotoxicosis was characterized by long-term (11.8±3.6-day) neuromuscular disorders, while in SHM of another etiology, there were shorter (5.8±4-day) muscle weakness episodes (p<0.05). The SHM duration was recorded to be shorter in 4 pregnant women (4.3±4 days) than that in the other patients (10.3±2.9 days) (p<0.05). In nontraumatic rhabdomyolysis, the duration of hypokalemic paralysis (HP) was significantly longer (9±1.4 days) than in pregnancy (4.3±3.9 days). The episodes of HP in thyrotoxicosis and aldosteroma turned out to be longer (495.8±331.5 days) (p<0.05) than those in the presence of electrolyte changes in pregnant women and in rhabdomyolysis (14±5.7 days). In patients without adrenal tumors, thyrotoxicosis, the SHM periods requiring urgent hospitalization were more prolonged in nontraumatic rhabdomyolysis (30±8.5 days) (p<0.05) than those in the presence with electrolyte disorders in pregnant women (11.2±3.7 days).Conclusion. The differential diagnostic algorithm for examining patients with acute flaccid paralysis of various etiologies due to hypokalemia has not been well elaborated, especially in endocrine disease and rhabdomyolysis. The differences in the rate of hypokalemia reversal in hyperaldosteronism, thyrotoxicosis, and rhabdomyolysis are likely to be associated with the multifactorial etiology of SHM. An incorrect assessment of the etiology of SHM is a common reason for its late diagnosis and inadequate treatment.

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Thyrotoxic Periodic Paralysis Crosses Boarders From Muscles to the Heart: A Case of Hypokalemic Ventricular Tachycardia

Cited by 2 publications

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Sudden weakness due to thyrotoxic periodic paralysis: a case report

Sudden weakness due to thyrotoxic periodic paralysis: a case report

Secondary hypokalemic myoplegias

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