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A case report of sudden-onset upper and lower extremity weakness
Heba Haddad1, Michael Rotblatt
1Internal Medicine Resident, Olive View-UCLA Medical Center , Sylmar, CA , USA.
Thyrotoxic hypokalemic periodic paralysis, a serious complication of hyperthyroidism, causes acute muscle weakness. Prompt treatment of hyperthyroidism and potassium repletion can reverse paralysis.
Area of Science:
- Endocrinology
- Neurology
- Internal Medicine
Background:
- Thyrotoxic hypokalemic periodic paralysis (THPP) is a medical emergency characterized by acute paralysis, hypokalemia, and thyrotoxicosis.
- Fatal ventricular arrhythmias have been reported in association with hypokalemia.
- Early recognition and management are crucial due to its potentially lethal nature.
Observation:
- A 24-year-old man presented with acute, severe weakness in his lower extremities, progressing to his trunk and arms.
- Physical examination revealed bilateral extremity weakness and a palpable goiter.
- Laboratory results showed profound hypokalemia (potassium 2.0 mEq/L) and a thyroid panel consistent with hyperthyroidism.
Findings:
- The patient's symptoms resolved completely after potassium repletion and treatment of hyperthyroidism.
- Diagnosis of thyrotoxic hypokalemic periodic paralysis was confirmed.
Implications:
- THPP is a potentially lethal but reversible complication of hyperthyroidism.
- Early recognition and management of hyperthyroidism are imperative for successful treatment and patient outcomes.
- This case highlights the importance of considering THPP in patients presenting with unexplained paralysis and hypokalemia.
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