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Insulin-induced severe thyrotoxic periodic paralysis: A case report
1Department of Endocrinology and Metabolism, Zigong First People's Hospital, Zigong 643000, Sichuan Province, China. wylisc@yeah.net.
World Journal of Clinical Cases
|March 7, 2025
Summary
Insulin can trigger thyrotoxic periodic paralysis (TPP), a serious endocrine emergency causing hypokalemia and muscle weakness. Avoid insulin in hyperthyroid patients to prevent TPP attacks.
Area of Science:
- Endocrinology
- Neurology
Background:
- Thyrotoxic periodic paralysis (TPP) is a critical endocrine condition linked to thyrotoxicosis.
- It presents with periodic muscle weakness and hypokalemia, posing significant health risks.
Observation:
- A 38-year-old male with type 2 diabetes experienced severe TPP after initiating insulin therapy.
- He presented with profound limb weakness and critical hypokalemia (1.6 mmol/L).
Findings:
- Insulin administration was identified as the likely trigger for TPP in this hyperthyroid patient.
- Discontinuation of insulin and potassium repletion resolved the paralysis and hypokalemia.
Implications:
- Insulin should be avoided in patients with hyperthyroidism to prevent TPP.
- Prompt diagnosis and management of TPP are essential, particularly in hypokalemic periodic paralysis cases.
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