Thyrotoxic periodic paralysis. A case report

Abstract

Thyrotoxic hypokalemic periodic paralysis (TPP)--a rare complication of thyrotoxicosis and a medical emergency--is characterized by recurrent episodes of muscle weakness and hypokalemia associated with hyperthyroidism. We report a case of TPP in a 38-year-old white Lebanese male. The patient suffered from severe muscle weakness of the upper and lower limbs. His blood tests revealed hypokalemia (k: 2.4 mEq/L), low thyroid-stimulating hormone TSH (0.001 microIU/mL) and normal levels of thyroid hormones. The thyroid scan showed a hot nodule. His paralysis resolved with IV potassium. The patient was treated with propranolol and radioactive iodine with complete remission of the hyperthyroidism and the paralysis. A discussion of the clinical and pathophysiological features and treatment of TPP is presented.