Thyrotoxic Periodic Paralysis: Diversity in America

Patel, Hetain; Wilches, Lina Vanessa; Guerrero, Jorge

doi:10.1016/j.jemermed.2013.08.104

Cited by 14 publications

(22 citation statements)

References 23 publications

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“…TPP is diagnosed based on clinical and biochemical evidence of hyperthyroidism with hypokalaemia in a patient with a history of paralytic attacks 3. Attacks tend to occur more at night or early in the morning on awakening,5 as in our patient.…”

Section: Discussionmentioning

confidence: 83%

“…TPP usually affects middle-aged patients in their 20s–40s 8. The prototypical patient is a man of age >20 years and of Asian descent; however, it is being increasingly seen in the western world due to population mobility, admixture and increasing obesity leading to insulin resistance 3. Interestingly, unlike other thyroid disorders which are more common in females, TPP occurs more in men (male:female ratio of 20:1)7 due to the increased Na-K-ATPase activity from testosterone 6…”

Section: Discussionmentioning

confidence: 99%

“…An acute attack is usually transient and lasts hours to days, even without treatment 3. An acute episode is treated with potassium replacement but rebound hyperkalaemia can occur if excess potassium is supplemented as total body potassium is normal.…”

Section: Discussionmentioning

confidence: 99%

“…TPP is characterised by recurrent episodes of transient muscle weakness and hypokalaemia due to uncontrolled hyperthyroidism 2. It is often missed during initial attacks due to its rarity in the Western world and often mild hyperthyroid symptoms 3 4. TPP is rare but easily reversible.…”

Section: Introductionmentioning

confidence: 99%

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Paralysis that easily reverses: a case of thyrotoxic periodic paralysis

Tachamo¹,

Lohani

Nazir

et al. 2017

BMJ Case Reports

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Thyrotoxic periodic paralysis is a potentially life-threatening condition associated with recurrent episodes of muscle weakness and hypokalaemia due to hyperthyroidism. Diagnosis is often delayed or misdiagnosed due to its rarity in the western world and subtle features of hyperthyroidism on initial presentation. Here we present the case of a 25-year-old man who presented to the emergency department (ED) with sudden onset weakness of bilateral upper and lower extremities. His labs revealed hypokalaemia with elevated T4 and suppressed thyroid-stimulating hormone and he was diagnosed with thyrotoxic periodic paralysis. He was treated with potassium repletion, atenolol and methimazole with complete reversal of his paralysis within the next day. Unfortunately, he failed to keep the follow-up appointment after discharge, ran out of his methimazole and landed up in the ED again.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Paralysis that easily reverses: a case of thyrotoxic periodic paralysis

Tachamo¹,

Lohani

Nazir

et al. 2017

BMJ Case Reports

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“…8,9 Symptoms can progress to flaccid quadriplegia. 10 Myalgia can be seen in less than half of the patients. Reflexes can be normal or abnormal.…”

Section: Tppmentioning

confidence: 99%

Periodic Paralysis Syndromes: A T3 Thyrotoxicosis Etiology Presentation and Review of Literature

Chao¹,

Akhondi²

2020

HCA Healthcare Journal of Medicine

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DescriptionPeriodic paralysis is a group of muscle diseases that are related to transmembrane ion channels. Dysfunction of these channels causes an increase in sodium-potassium (Na-K) adenosine triphosphatase (ATPase) activity that pushes potassium into the cells that result in serum hypokalemia that manifests as muscle weakness. Beta-adrenergic stimulation and insulin sensitivity might also play a role.Periodic paralysis is divided into hereditary and acquired forms. Thyrotoxic periodic paralysis is an acquired form of periodic paralysis that manifests as muscle weakness, hypokalemia, and hyperthyroidism. The onset of the symptoms is mainly over the age of 20 and can be triggered by intense physical activity, stress, and excessive carbohydrate intake.This review presents the different types of this disease (hypokalemic, hyperkalemic, thyrotoxic, and Andersen-Tawil syndrome) while presenting a unique case of T3 thyrotoxicosis causing periodic paralysis.

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