Thyrotoxic periodic paralysis in a patient with Graves' disease: A case report.
Publication/Presentation Date
9-1-2022
Abstract
INTRODUCTION AND IMPORTANCE: Thyrotoxic periodic paralysis (TPP) is a rare and often misdiagnosed, hypokalemic periodic paralysis with features of mainly recurrent acute limb weakness with good treatment outcome if diagnosed early.
CASE PRESENTATION: We here report a case of a 25-year-old male with a history of recurrent bilateral upper and lower limbs weakness resolved by potassium infusion later found to have Thyrotoxicosis (Graves' disease). MRI scans of the brain had no abnormal finding while thyroid scintigraphy showed diffuse toxic goiter.
CLINICAL DISCUSSION: Graves' disease shares a majority of TPP while, other causes like toxic adenoma, thyroiditis, toxic multinodular goiter, amiodarone induced thyrotoxicosis, levothyroxine intoxication and thyrotropin (TSH) producing pituitary adenoma are also associated with TPP. The management of thyrotoxicosis by medical therapy, surgery or radioactive iodine therapy is the mainstay of treatment of TPP patients. For the treatment of acute attacks, potassium administration is necessary keeping in mind the problem of hyperkalemia because of excess doses of potassium as it shifts to extracellular space.
CONCLUSION: TPP should be considered as a differential in the cases of limb weakness and the secondary causes especially Thyrotoxicosis and precipitating factors should be identified.
Volume
81
First Page
104447
Last Page
104447
ISSN
2049-0801
Published In/Presented At
Kharel, S., Ojha, R., Parajuli, N., Bhattarai, S., Parajulee, G., Karn, R., Gajurel, B. P., Rajbhandari, R., Gautam, N., & Shrestha, A. (2022). Thyrotoxic periodic paralysis in a patient with Graves' disease: A case report. Annals of medicine and surgery (2012), 81, 104447. https://doi.org/10.1016/j.amsu.2022.104447
Disciplines
Medicine and Health Sciences
PubMedID
36147095
Department(s)
Fellows and Residents
Document Type
Article