A Case of Thyrotoxic Periodic Paralysis Associated with Transient Thyrotoxicosis

Hye Jung Kwon; Young Sik Choi; Joon Seup Lee; Dong Hyun Park; Yeon Jung Choi; Jin Seok Yoo

doi:10.7180/kmj.2012.27.2.167

Journal List > Kosin Med J > v.27(2) > 1056974

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kwon, Choi, Lee, Park, Choi, and Yoo: A Case of Thyrotoxic Periodic Paralysis Associated with Transient Thyrotoxicosis

Case Report

Kosin Medical Journal

Kosin Medical Journal 2012; 27(2): 167-171.

Published online: 27 December 2012

DOI: https://doi.org/10.7180/kmj.2012.27.2.167

A Case of Thyrotoxic Periodic Paralysis Associated with Transient Thyrotoxicosis

Hye Jung Kwon, Young Sik Choi, Joon Seup Lee, Dong Hyun Park, Yeon Jung Choi, Jin Seok Yoo

Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea.

Corresponding Author: Young Sik Choi, Department of Internal Medicine, College of Medicine, Kosin University, 34, Amnam-dong, Seo-gu, Busan 602-702, Korea. TEL: +82-51-990-6102, FAX: +82-51-248-5686, yschoi@ns.kosinmed.or.kr

Received 23 April 2012 Revised 25 April 2012 Accepted 7 June 2012

Abstract

Thyrotoxic periodic paralysis is an acute muscle weakness of the limbs associated with hypokalemia. It can occur with any form of thyrotoxicosis. Thyrotoxic periodic paralysis associated with transient thyrotoxicosis due to thyroiditis is very rare. We experienced a case of thyrotoxic periodic paralysis associated with transient thyrotoxicosis. A 39-yr-old man was referred to our hospital because of paralysis of upper and lower extremity. The laboratory results were hypokalemia and mild thyrotoxicosis. A thyroid scan with Tc-99m revealed decreased uptake in the thyroid area compatible with destructive thyroiditis. The paralytic attack did not recur after the patient recovered to euthyroid state.

Keywords: Thyrotoxic periodic paralysis, Transient thyrotoxicosis

Figures and Tables

Fig. 1

Electrocardiography reveals sinus tachycardia, nonspecific T wave abnormalities, and mild high QRS voltage criteria.

Fig. 2

Ultrasonography of the neck. A sonogram reveals a decreased echo in right lobe of thyroid gland.

Fig. 3

Tc-99m thyroid scan revealed decrease uptake of tracers.

References

1. Kung AW. Clinical review: Thyrotoxic periodic paralysis: a diagnostic challenge. J Clin Endocrinol Metab. 2006. 91:2490–2495.

2. Hsu FS, Tsai WS, Chau T, Chen HH, Chen YC, Lin SH. Thyrotropin-secreting pituitary adenoma presenting as hypokalemic periodic paralysis. Am J Med Sci. 2003. 325:48–50.

3. Lee JI, Sohn TS, Son HS, Oh SJ, Kwon HS, Chang SA, et al. Thyrotoxic periodic paralysis presenting as polymorphic ventricular tachycardia induced by painless thyroiditis. Thyroid. 2009. 19:1433–1434.

4. Chan A, Shinde R, Chow CC, Cockram CS, Swaminathan R. In vivo and in vitro sodium pump activity in subjects with thyrotoxic periodic paralysis. BMJ. 1991. 303:1096–1099.

5. Layzer RB. Periodic paralysis and the sodium-potassium pump. Ann Neurol. 1982. 11:547–552.

6. Shishiba Y, Shimizu T, Saito T, Shizuma K. Elevated immunoreactive insulin concentration during spontaneous attacks in thyrotoxic periodic paralysis. Metabolism. 1972. 21:285–290.

7. Loh KC, Pinheiro L, Ng KS. Thyrotoxic periodic paralysis complicated by near-fatal ventricular arrhythmias. Singapore Med J. 2005. 46:88–89.

8. Manoukian MA, Foote JA, Crapo LM. Clinical and metabolic features of thyrotoxic periodic paralysis in 24 episodes. Arch Intern Med. 1999. 159:601–606.

9. Ryan DP, da Silva MR, Soong TW, Fontaine B, Donaldson MR, Kung AW, et al. Mutations in potassium channel Kir2.6 cause susceptibility to thyrotoxic hypokalemic periodic paralysis. Cell. 2010. 140:88–98.

10. Hsu YJ, Lin YF, Chau T, Liou JT, Kuo SW, Lin SH. Electrocardiographic manifestations in patients with thyrotoxic periodic paralysis. Am J Med Sci. 2003. 326:128–132.

TOOLS

Similar articles