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Órgano Oficial del Hospital Angeles Health System

2006, Number 2

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Acta Med 2006; 4 (2)

Thyrotoxic hypokalemic paralysis: report of four cases

Domínguez-Carrillo LG, Arellano-Aguilar JG

Language: Spanish
References: 33
Page: 117-121
PDF size: 88.03 Kb.


ABSTRACT

Thyrotoxic periodic paralysis (TPP), a hyperthyroidism related hypokalemia and muscle-weakening condition resulting from a sudden shift of potassium into cells, many patients with TPP have no obvious symptoms related to hyperthyroidism. Therefore, several important clues may help in diagnosing and managing TPP: presentation in an adult male with no family history of periodic paralysis; presence of systolic hypertension, tachycardia, high QRS voltage, first-degree atrioventricular block on electrocardiography; presence of low amplitude electrical compound muscle action potential on electromyography and no notable changes in amplitudes after low doses of epinephrine; electrolyte findings such: hypokalemia with low urinary potassium excretion, hypophosphatemia associated with hypophosphaturia, and hypercalciuria. Immediate therapy with potassium chloride supplementation may foster a rapid recovery of muscle strength, but with a risk of rebound hyperkalemia. Nonselective b-blockers may provide an alternative choice. Long-term therapy with definite control of hyperthyroidism completely abolishes attacks. We present our experience with four cases from Hospital Angeles Leon.


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