Pediatr. praxi. 2016;17(6):379-382 | DOI: 10.36290/ped.2016.083

Thyrotoxic periodic paralysis

prof. MUDr. Zdeněk Doležel, CSc., MUDr. Dana Novotná, Ph.D., MUDr. Helena Schneiderová, MUDr. Jan Papež, MUDr. Martin Jouza
Pediatrická klinika LF MU a FN Brno

The majority of the body potassium is distributed in the intracellular space, and of which about 80% is in skeletal muscle. Movement of potassium in and out of skeletal muscle thus plays a pivotal role in extracellular potassium homeostasis. Thyrotoxic periodic paralysis (TPP) is a potentially lethal and rare complication of hyperthyroidism characterized by recurrent muscle weakness and hypokalemia. Acidobasic status is not impaired, however hypomagnesemia and hypophosphatemia may be also present. The diagnosis of TPP is confirmed on the basis of abnormal thyroid hormones. We describe a case of 17-year-old male who presented with acute onset weakness and hypokalemia. He was subsequently diagnosed with Graves’-Basedow disease.

Keywords: hypokalemia, hyperthyroidism, hypokalemic periodic paralysis

Published: December 1, 2016  Show citation

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Doležel Z, Novotná D, Schneiderová H, Papež J, Jouza M. Thyrotoxic periodic paralysis. Pediatr. praxi. 2016;17(6):379-382. doi: 10.36290/ped.2016.083.
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References

  1. Hegde S, Shaik MA, Gummadi T. Hypokalaemic periodic paralysis in a patient with subclinical hyperthyroidism: a rare case. Journal of clinical and diagnostic research 2016; 10: OD14-15. Go to original source... Go to PubMed...
  2. Tella SH, Kommalapati A. Thyrotoxic periodic paralysis: an underdiagnosed and underrecognized condition. Cureus 2015; 7: e342. Go to original source... Go to PubMed...
  3. Al-Zubeidi H, Demeterco C, Jones KL. Thyrotoxic, hypokalemic periodic paralysis (THPP) in adolescents. J Pediatr Endocrinol Metab 2015; 28: 157-161. Go to original source... Go to PubMed...
  4. Wang XY, Ren BW, Yong ZH, et al. Mutation analysis of CACNA1S and SCN4A in patients with hypokalemic periodic paralysis. Mol Med Rep 2015; 12: 6267-6274. Go to original source... Go to PubMed...
  5. Park S, Kim TY, Sim S, et al. Thyrotoxic periodic paralysis and polymorphism of the ADRB2, AR, and GABRA3 genes in men with Graves disease. Endocrinol Metab 2016; 31: 142-146. Go to original source... Go to PubMed...
  6. Zheng J, Liang Z, Liu F, et al. A novel Kir2.6 mutation associated with hypokalemic periodic paralysis. Clin Neurophysiol 2016; 127: 2503-2508. Go to original source... Go to PubMed...
  7. Ryan DP, da Silva MR, Soong TW, et al. Mutations in potassium channel Kir2.6 cause susceptibility to thyrotoxic hypokalemic periodic paralysis. Cell 2010; 140: 88-98. Go to original source... Go to PubMed...
  8. Rhee EP, Scott JA, Dighe AS. Case records of the Massachusetts General Hospital. Case 4 - 2012. A 37-year-old man with muscle pain, weakness, and weight loss. N Engl J Med 2012; 366: 553-560. Go to original source... Go to PubMed...
  9. Cheng ChJ, Kuo E, Huang ChL. Extracellular potassium homeostasis: insight from hypokalemic periodic paralysis. Semin Nephrol 2013; 33: 237-247. Go to original source... Go to PubMed...
  10. Yardimci B, Kazancioglu R. A rare case of paralysis in an endemic area. Pak J Med Sci 2015; 31: 480-482. Go to original source... Go to PubMed...
  11. Kratochvíl J, Masopust V, Martínková J, et al. Hypokalemická periodická paralýza u pacientů s hypertyreózou. Vnitř Lék 2008; 54: 1100-1101. Go to PubMed...
  12. Bertola G, Ausenda C, Bocchia M, et al. Bulbar paralysis and flaccid tetraparesis in thyrotoxicosis. Recenti Prog Med 2002; 93: 169-171.
  13. Yang SPL, Wu PH, Tey BH, et al. A patient with thyroid storm presenting with apathetic thyrotoxicosis and features of meningoencephalitis. Thyroid 2011; 21: 675-678. Go to original source... Go to PubMed...
  14. Hakami O, Ahmad MH, Al Johani N. A case of nonfatal ventriculat arrhythmia due to thyrotoxic periodic paralysis in a Saudi patient as an initial presentation of Graves'Disease. Clinical Medicine Insight: case report 2016; 9: 5-9. Go to original source...
  15. Wang HF, Tsai SC, Pan MS, et al. Complete heart block during potassium therapy in thyrotoxic periodic paralysis. J Emerg Med 2013; 44: 61-64. Go to original source... Go to PubMed...
  16. Anjo D, Maia J, Carvalho AC, et al. Thyroid storm and arrhytmic storm: a potentially fatal combination. Am J Emerg Med 2013; 31: e3-e5. Go to original source... Go to PubMed...
  17. Grym J, Goldemund K. Základy rehydratační léčby v pediatrii. Olomouc: Solen ed. Meduca: 2013: 270 s.
  18. Viera AJ, Wouk N. Potassium disorders: hypokalemia and hyperkalemia. Am Fam Physician 2015; 92: 487-495. Go to PubMed...
  19. Satam N, More V, Shanbag P, et al. Fatal thyrotoxic periodic paralysis with normokalemia. Indian J Pediatr 2007; 74: 1041-1043. Go to original source... Go to PubMed...
  20. Chakrabarti S. Normokalaemic thyrotoxic periodic paralysis with preserved reflexes - a unique case report. Journal of clinical and diagnostic research 2015; 9: OD5-6. Go to original source... Go to PubMed...
  21. Valizadeh N, Zarrin S. A 32-year-old man with normokalemic thyrotoxic periodic paralysis. Malays J Med Sci 2013; 20: 81-83.




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