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Recurrent hypokalemic paralysis in hypothyroidism
Jitendra Singh1, Anju Dinkar2, Nilesh Kumar1
1Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
The American Journal of the Medical Sciences
|February 8, 2023
Summary
Hypothyroidism can rarely present as recurrent hypokalemic paralysis. Prompt potassium correction and thyroxine treatment led to full recovery in two patients, highlighting an unusual but treatable manifestation of this common thyroid disorder.
Area of Science:
- Endocrinology
- Neurology
Background:
- Hypothyroidism is a common endocrine disorder typically presenting with recognizable symptoms.
- Unusual presentations can delay diagnosis, necessitating broader clinical awareness.
Observation:
- Two middle-aged patients (34M, 37F) presented with recurrent hypokalemic paralysis, characterized by quadriparesis, hypotonia, and diminished reflexes without autonomic dysfunction.
- Initial investigations revealed severe hypokalemia (1.4 and 1.9 mEq/L).
Findings:
- Biochemical analysis confirmed autoimmune hypothyroidism with elevated thyroid-stimulating hormone and thyroid-related antibodies.
- Recurrent hypokalemic paralysis is a rare initial manifestation of hypothyroidism.
Implications:
- This case series underscores the importance of considering hypothyroidism in patients with unexplained hypokalemic paralysis.
- Early diagnosis and management with potassium repletion and thyroxine supplementation are crucial for favorable outcomes.
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