Steroid-induced Hypokalemic Periodic Paralysis

Area of Science:

• Neurology
• Endocrinology
• Genetics

Background:

• Hypokalemic periodic paralysis (HypoPP) is a rare neuromuscular disorder characterized by episodic muscle weakness linked to low serum potassium levels.
• It is often associated with ion channelopathies, specifically involving calcium and sodium channels, and can be triggered by various factors.
• While typically hereditary, acquired forms can occur, presenting a diagnostic challenge.

Purpose of the Study:

• To present a case of Hypokalemic periodic paralysis (HypoPP) triggered by glucocorticoid administration.
• To highlight the importance of considering HypoPP in patients presenting with acute muscle weakness after glucocorticoid treatment.
• To emphasize the need for timely diagnosis and management of HypoPP to prevent potential long-term complications.

Main Methods:

• Case report of a 37-year-old male patient.
• Detailed clinical presentation including symptoms and laboratory findings.
• Review of relevant literature on HypoPP and glucocorticoid-induced complications.

Main Results:

• The patient experienced bilateral lower limb weakness associated with severe hypokalemia.
• The onset of symptoms was temporally linked to the intramuscular administration of 8 mg dexamethasone.
• The case illustrates a rare but significant adverse effect of glucocorticoid therapy.

Conclusions:

• Hypokalemic periodic paralysis (HypoPP) can be precipitated by glucocorticoid therapy, even in the absence of a known hereditary predisposition.
• Clinicians should maintain a high index of suspicion for HypoPP in patients with acute muscle weakness following glucocorticoid use.
• Prompt recognition and management of HypoPP are crucial for patient recovery and preventing permanent muscle damage.