Thyrotoxic hypokalemic periodic paralysis: six cases in non-Asian patients

To describe six cases of thyrotoxic hypokalemic periodic paralysis (THPP) in non-Asian men.

We present six cases of THPP, including clinical and laboratory findings, treatment, and outcome, and review the related literature.

Hypokalemic periodic paralysis is a relatively common occurrence in Asian men with thyrotoxicosis; however, it is unusual in non-Asian patients with thyrotoxicosis. Among our six patients--four Caucasians, one African-American, and one Hispanic--the precipitating factors, initial manifestations, and clinical course varied. In general, treatment with 131 I or potassium eliminated the paralytic episodes.

THPP needs to be distinguished from nonthyrotoxic hypokalemic periodic paralysis. Although THPP is unusual in non-Asian men, it must be recognized because of the severe and potentially fatal complications, which are reversible with potassium replacement and antithyroid therapy.