Hypokalemic Paralysis Complicated by Concurrent Hyperthyroidism and Chronic Alcoholism. Issue 39 (September 2015)

• Record Type: Journal Article
• Authors: Tsai, Ming-Hsien; Lin, Shih-Hua; Leu, Jyh-Gang; Fang, Yu-Wei; Mubarak., Muhammed
• Is Part Of: Medicine. Volume 94:Issue 39(2015)
• Publication Date: 2015-09
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000001689
• Languages: English
• ISSNs: 0025-7974

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Abstract</title> <p>Thyrotoxic periodic paralysis (TPP) is characterized by the presence of muscle paralysis, hypokalemia, and hyperthyroidism. We report the case of a young man with paralysis of the lower extremities, severe hypokalemia, and concurrent hyperthyroidism. TPP was suspected; therefore, treatment consisting of judicious potassium (K⁺) repletion and β-blocker administration was initiated. However, urinary K⁺ excretion rate, as well as refractoriness to treatment, was inconsistent with TPP. Chronic alcoholism was considered as an alternative cause of hypokalemia, and serum K⁺ was restored through vigorous K⁺ repletion and the addition of K⁺-sparing diuretics.</p> <p>The presence of thyrotoxicosis and hypokalemia does not always indicate a diagnosis of TPP. Exclusion of TPP can be accomplished by immediate evaluation of urinary K⁺ excretion, acid-base status, and the amount of potassium chloride required to correct hypokalemia at presentation.</p> </sec> </abstract>