Thyrotoxic Periodic Paralysis with Thyroid Storm as the First Presentation of Graves’ disease; a Case Report
Archives of Academic Emergency Medicine,
Vol. 9 No. 1 (2021),
1 January 2021
,
Page e19
https://doi.org/10.22037/aaem.v9i1.1083
Abstract
Thyrotoxic periodic paralysis is a rare endocrine emergency that manifests as acute onset muscle weakness and hypokalaemia secondary to thyrotoxicosis. It mainly occurs due to rapid and dramatic intracellular shift of potassium resulting in hypokalaemia and acute flaccid paralysis. This condition predominantly affects males of Asian descent, and presentation can range from mild generalized weakness to complete quadriplegia, as seen in our case. We herein report a case of a 40-year-old female, who presented to us with acute onset flaccid quadriplegia and thyroid storm, which is the first ever manifestation of previously undiagnosed Grave’s disease. Liver abscess was found to be the underlying trigger for thyrotoxic paralysis and thyroid storm.
- Hypokalemic Periodic Paralysis
- Thyrotoxicosis
- Graves disease
- Quadriplegia
- Thyroid Crisis
How to Cite
References
Carroll R, Matfin G. Endocrine and metabolic emergencies: thyroid storm. Therapeutic advances in endocrinology and metabolism. 2010;1(3):139-45.
Salih M, van Kinschot C, Peeters R, de Herder W, Duschek E, Van Der Linden J, et al. Thyrotoxic periodic paralysis: an unusual presentation of hyperthyroidism. Neth J Med. 2017;75(8):315-20.
Lam L, Nair RJ, Tingle L, editors. Thyrotoxic periodic paralysis. Baylor University Medical Center Proceedings; 2006: Taylor & Francis.
Abbasi B, Sharif Z, Sprabery LR, Lopez FA. Hypokalemic thyrotoxic periodic paralysis with thyrotoxic psychosis and hypercapnic respiratory failure. The American journal of the medical sciences. 2010;340(2):147-53.
Qian Y-Y, Dai Z-J, Zhu C, Zhu Y-X, Wu C-M. Thyrotoxic periodic paralysis complicated by life-threatening acute hypercapnic respiratory failure in a Chinese male with painless thyroiditis. The American journal of emergency medicine. 2019;37(2):379. e1-. e3.
Stasiolek M, editor Neurological symptoms and signs in thyroid disease. Thyroid Research; 2015: Springer.
Jandhyala SN, Madireddi J, Belle J, Rau N, Shetty R. Hypokalaemic periodic paralysis–A prospective study of the underlying etiologies. Journal of clinical and diagnostic research: JCDR. 2015;9(9):OC17.
Meseeha M, Parsamehr B, Kissell K, Attia M. Thyrotoxic periodic paralysis: a case study and review of the literature. Journal of community hospital internal medicine perspectives. 2017;7(2):103-6.
Kung AW. Thyrotoxic periodic paralysis: a diagnostic challenge. The Journal of Clinical Endocrinology & Metabolism. 2006;91(7):2490-5.
Wu C-Z, Wu Y-K, Lin J-D, Kuo S-W. Thyrotoxic periodic paralysis complicated by acute hypercapnic respiratory failure and ventricular tachycardia. Thyroid. 2008;18(12):1321-4.
Chang C-C, Cheng C-J, Sung C-C, Chiueh T-S, Lee C-H, Chau T, et al. A 10-year analysis of thyrotoxic periodic paralysis in 135 patients: focus on symptomatology and precipitants. European Journal of Endocrinology. 2013;169(5):529.
Cheng C-J, Lin S-H, Lo Y-F, Yang S-S, Hsu Y-J, Cannon SC, et al. Identification and functional characterization of Kir2. 6 mutations associated with non-familial hypokalemic periodic paralysis. Journal of Biological Chemistry. 2011;286(31):27425-35.
Shiang J-C, Cheng C-J, Tsai M-K, Hung Y-J, Hsu Y-J, Yang S-S, et al. Therapeutic analysis in Chinese patients with thyrotoxic periodic paralysis over 6 years. European journal of endocrinology. 2009;161(6):911.
- Abstract Viewed: 1029 times
- pdf Downloaded: 489 times
