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Medicina & Laboratorio

2020, Number 3

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Medicina & Laboratorio 2020; 24 (3)

Thyrotoxic hypokalemic periodic paralysis: case report and literature review

Moreno-Rozo NK, Rosero-Arellano CH, García-Castaño S

Language: Spanish
References: 26
Page: 245-254
PDF size: 544.70 Kb.


ABSTRACT

Thyrotoxic hypokalemic periodic paralysis belongs to the primary periodic paralysis disorders, and presents as a complication of thyrotoxicosis. It is more common in male patients of Asian descent. It is characterized by recurrent episodes of sudden onset of limb weakness, associated with severe hypokalemia in a patient with underlying thyrotoxicosis. We present the case of a 32-year-old man, obese, who started his clinical manifestations with progressive weakness of the lower and upper limbs, which limited walking almost entirely. He referred having presented the same clinical manifestations a few months ago, with spontaneous improvement. Paraclinical tests showed hypokalemia 1,6 mmol/L, and a biochemical profile of thyrotoxicosis with suppressed TSH, and elevated T3 and T4, positive anti-peroxidase antibodies, and thyroid scintigraphy with diffuse goiter, confirming the thyrotoxic hypokalemic periodic paralysis diagnosis, associated with Graves’ disease. Hypokalemia was rapidly corrected with an intravenous infusion of potassium, with clinical improvement. Hyperthyroidism was managed with beta-blockers, thionamides, and subsequently with radioactive iodine.


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