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Thyrotoxic Periodic Paralysis: An Underdiagnosed and Under-recognized Condition.
Sri Harsha Tella1, Anuhya Kommalapati2
1Endocrinology, Diabetes and Metabolism, National Institute of Health ; Nutrition, NICHD/NIH.
Cureus
|December 2, 2015
Summary
Thyrotoxic hypokalemic periodic paralysis (TPP) is a rare condition causing muscle paralysis and low potassium due to hyperthyroidism. Prompt diagnosis and treatment, including beta-blockers and potassium, are crucial for managing TPP and preventing complications.
Area of Science:
- Endocrinology
- Neurology
Background:
- Thyrotoxic hypokalemic periodic paralysis (TPP) is a rare but serious manifestation of hyperthyroidism.
- It presents as episodic muscle paralysis linked to acute hypokalemia without total body potassium depletion.
Observation:
- Two cases of TPP are presented, with severe hypokalemia (1.3 mEq/L and 1.2 mEq/L) and no prior medical history.
- Clinical signs included tachycardia, palpitations, and exophthalmos, leading to suspicion of TPP.
Findings:
- Laboratory workup confirmed thyrotoxicosis, with patients diagnosed with Graves' disease.
- Treatment with beta-blockers and intravenous potassium chloride led to symptomatic improvement.
Implications:
- Early recognition of TPP in hyperthyroid patients is vital for prompt diagnosis and management.
- Effective treatment, including addressing the underlying thyrotoxicosis with methimazole, prevents recurrent paralysis and cardiac arrhythmias.
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