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Case Reports
. 2017 Jan 4:18:12-16.
doi: 10.12659/ajcr.901793.

Hypokalemic Paralysis Complicated by Concurrent Hyperthyroidism and Hyperaldosternoism: A Case Report

Yu-Hsin Hsiao  1 , Yu-Wei Fang  1   2 , Jyh-Gang Leu  1   2 , Ming-Hsein Tsai  1   2
Affiliations
Case Reports

Hypokalemic Paralysis Complicated by Concurrent Hyperthyroidism and Hyperaldosternoism: A Case Report

Yu-Hsin Hsiao et al. Am J Case Rep. .

Abstract

BACKGROUND Thyrotoxic periodic paralysis (TPP) is commonly observed in patients with acute paralysis and hyperthyroidism. However, there is a possibility of secondary causes of hypokalemia in such a setting. CASE REPORT Herein, we present the case of a 38-year-old woman with untreated hypertension and hyperthyroidism. She presented with muscle weakness, nausea, vomiting, and diarrhea since one week. The initial diagnosis was TPP. However, biochemistry tests showed hypokalemia with metabolic alkalosis and renal potassium wasting. Moreover, a suppressed plasma renin level and a high plasma aldosterone level were noted, which was suggestive of primary aldosteronism. Abdominal computed tomography confirmed this diagnosis. CONCLUSIONS Therefore, it is imperative to consider other causes of hypokalemia (apart from TPP) in a patient with hyperthyroidism but with renal potassium wasting and metabolic alkalosis. This can help avoid delay in diagnosis of the underlying disease.

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Conflict of interest statement

Conflicts of Interest: None declared Statement No financial support in the form of grants. The authors report no conflicts of interest.

Figures

Figure 1.
Figure 1.
Contrast-enhanced abdominal CT showing a mass lesion (30 mm) on the left adrenal gland (arrow).
Figure 2.
Figure 2.
Schematic illustration of the recommended diagnostic approach to hypokalemia.
See this image and copyright information in PMC

References

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