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Thyrotoxic Periodic Paralysis: A Case Report and Literature Review

Department of Endocrinology and Nutrition Hospital Sant Pau, Autonomous University of Barcelona (UAB), Spain

I. Vinagre

Department of Endocrinology and Nutrition Hospital Sant Pau, Autonomous University of Barcelona (UAB), Spain

L. Sojo

Department of Endocrinology and Nutrition, Hospital Sant Pau, Autonomous University of Barcelona (UAB), Spain

J. M. Cubero

Department of Endocrinology and Nutrition, Hospital Sant Pau, Autonomous University of Barcelona (UAB), Spain

Antonio Pérez

Department of Endocrinology and Nutrition, Hospital Sant Pau, Autonomous University of Barcelona (UAB), Spain

Reprint Requests: Antonio Pérez, Department of Endocrinology, Hospital Sant Pau, S. Antoni M. Claret 167, 08025, Barcelona, Spain, Tel: +34 93-5565661, Fax: +34 93 5565727, E-mail:aperez{at}santpau.cat

Abstract

We describe a 37-year-old man with a 4-month history of episodic muscular weakness, involving mainly lower-limbs. Hypokalemia was documented in one episode and managed with intravenous potassium chloride. Hyperthyroidism was diagnosed 4 months after onset of attacks because of mild symptoms. The patient was subsequently diagnosed as having thyrotoxic periodic paralysis associated with Graves' disease. Treatment with propranolol and methimazol was initiated and 1 year later he remains euthyroid and symptoms free. Thyrotoxic periodic paralysis is a rare disorder, especially among Caucasians, but it should always be considered in patients with acute paralysis and hypokalemia, and thyroid function should be evaluated.

Key Words: Hyperthyroidism • Hypokalemia • Thyrotoxic periodic paralysis