Thyrotoxic Periodic Paralysis with Hypokalemia in an Adult Male from Nepal: A Case Report. 2019

Sabina Khadka, and Indu K C, and Rabindra Jang Rayamajhi, and Pravakar Dawadi, and Pravash Budhathoki
Nepalese Army Institute of Health Sciences, Sanobharyang, Kathmandu, Nepal.

Thyrotoxic periodic paralysis is rare complication of hyperthyroidism characterized by the sudden onset of hypokalemia and muscle paralysis. It is typically present in young Asian males. There are very few literatures regarding the occurrence of thyrotoxic hypokalemic periodic paralysis in Nepal. We reported a case of a 35-year-old male presented with the chief complaints of weakness of all four limbs of 1 day duration. He was diagnosed as a case of hyperthyroidism in the past, received treatment for 6 months and left medications on his own 6 months ago. Evaluation during admission revealed severe hypokalemia with serum potassium level 1.3mEq/l and high serum Triiodothyronine (>20.00µg/L) and low serum Thyroid Stimulating Hormone (<0.01µg/L). Potassium supplements resolved muscle weakness and the patient was restarted with anti-thyroid drugs. Hence, hypokalemic paralysis is a reversible cause of paralysis and high index of suspicion as well as timely interventions are required to prevent potential harm. Keywords: hyperthyroidism; hypokalemia; muscle paralysis; thyrotoxic periodic paralysis.

UI MeSH Term Description Entries
D006980 Hyperthyroidism Hypersecretion of THYROID HORMONES from the THYROID GLAND. Elevated levels of thyroid hormones increase BASAL METABOLIC RATE. Hyperthyroid,Primary Hyperthyroidism,Hyperthyroidism, Primary,Hyperthyroids
D006996 Hypocalcemia Reduction of the blood calcium below normal. Manifestations include hyperactive deep tendon reflexes, Chvostek's sign, muscle and abdominal cramps, and carpopedal spasm. (Dorland, 27th ed) Hypocalcemias
D007008 Hypokalemia Abnormally low potassium concentration in the blood. It may result from potassium loss by renal secretion or by the gastrointestinal route, as by vomiting or diarrhea. It may be manifested clinically by neuromuscular disorders ranging from weakness to paralysis, by electrocardiographic abnormalities (depression of the T wave and elevation of the U wave), by renal disease, and by gastrointestinal disorders. (Dorland, 27th ed) Hypopotassemia,Hypokalemias,Hypopotassemias
D008297 Male Males
D010243 Paralysis A general term most often used to describe severe or complete loss of muscle strength due to motor system disease from the level of the cerebral cortex to the muscle fiber. This term may also occasionally refer to a loss of sensory function. (From Adams et al., Principles of Neurology, 6th ed, p45) Palsy,Plegia,Todd Paralysis,Todd's Paralysis,Palsies,Paralyses,Paralysis, Todd,Paralysis, Todd's,Plegias,Todds Paralysis
D010507 Periodicity The tendency of a phenomenon to recur at regular intervals; in biological systems, the recurrence of certain activities (including hormonal, cellular, neural) may be annual, seasonal, monthly, daily, or more frequently (ultradian). Cyclicity,Rhythmicity,Biological Rhythms,Bioperiodicity,Biorhythms,Biological Rhythm,Bioperiodicities,Biorhythm,Cyclicities,Periodicities,Rhythm, Biological,Rhythmicities,Rhythms, Biological
D011188 Potassium An element in the alkali group of metals with an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte that plays a significant role in the regulation of fluid volume and maintenance of the WATER-ELECTROLYTE BALANCE.
D011433 Propranolol A widely used non-cardioselective beta-adrenergic antagonist. Propranolol has been used for MYOCARDIAL INFARCTION; ARRHYTHMIA; ANGINA PECTORIS; HYPERTENSION; HYPERTHYROIDISM; MIGRAINE; PHEOCHROMOCYTOMA; and ANXIETY but adverse effects instigate replacement by newer drugs. Dexpropranolol,AY-20694,Anaprilin,Anapriline,Avlocardyl,Betadren,Dociton,Inderal,Obsidan,Obzidan,Propanolol,Propranolol Hydrochloride,Rexigen,AY 20694,AY20694,Hydrochloride, Propranolol
D002231 Carbimazole An imidazole antithyroid agent. Carbimazole is metabolized to METHIMAZOLE, which is responsible for the antithyroid activity. Carbimazole Henning,Neo Tomizol,Neo-Mercazole,Neo-Thyreostat,Neomercazole
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

Related Publications

Sabina Khadka, and Indu K C, and Rabindra Jang Rayamajhi, and Pravakar Dawadi, and Pravash Budhathoki
June 2023, Cureus,
Sabina Khadka, and Indu K C, and Rabindra Jang Rayamajhi, and Pravakar Dawadi, and Pravash Budhathoki
February 2015, Clinical case reports,
Sabina Khadka, and Indu K C, and Rabindra Jang Rayamajhi, and Pravakar Dawadi, and Pravash Budhathoki
November 1989, The American journal of emergency medicine,
Sabina Khadka, and Indu K C, and Rabindra Jang Rayamajhi, and Pravakar Dawadi, and Pravash Budhathoki
September 2013, The Journal of emergency medicine,
Sabina Khadka, and Indu K C, and Rabindra Jang Rayamajhi, and Pravakar Dawadi, and Pravash Budhathoki
January 2007, Le Journal medical libanais. The Lebanese medical journal,
Sabina Khadka, and Indu K C, and Rabindra Jang Rayamajhi, and Pravakar Dawadi, and Pravash Budhathoki
January 2005, Acta medica portuguesa,
Sabina Khadka, and Indu K C, and Rabindra Jang Rayamajhi, and Pravakar Dawadi, and Pravash Budhathoki
January 2017, International journal of health sciences,
Sabina Khadka, and Indu K C, and Rabindra Jang Rayamajhi, and Pravakar Dawadi, and Pravash Budhathoki
January 2009, BMJ case reports,
Sabina Khadka, and Indu K C, and Rabindra Jang Rayamajhi, and Pravakar Dawadi, and Pravash Budhathoki
January 2021, Clinical case reports,
Sabina Khadka, and Indu K C, and Rabindra Jang Rayamajhi, and Pravakar Dawadi, and Pravash Budhathoki
January 2020, International journal of pediatric endocrinology,
Copied contents to your clipboard!