Key result
Intravenous potassium and magnesium supplementation rapidly reverses postoperative thyrotoxic periodic paralysis.
Why the study?
Thyrotoxic periodic paralysis is a rare, potentially life-threatening muscle disease in thyrotoxic patients that is easily missed due to a lack of knowledge.
Case Report (n=1)
No
Thyrotoxic periodic paralysis is an often unrecognized endocrine emergency causing acute muscle weakness and hypokalemia, which requires prompt recognition, cautious potassium supplementation, and correction of the hyperthyroid state to prevent life-threatening arrhythmias.
Thyrotoxic periodic paralysis (TPP) is a rare but potentially life-threatening muscle disease in a thyrotoxic patient. Due to the lack of knowledge, the diagnosis is easily missed. Diagnosis of TPP is made by documentation of hypokalemia and hyperthyroidism in acute generalized muscle weakness. Hypokalemia is caused by an intracellular shift of potassium because of an increased Na-K-ATPase pump activity and the inhibition of the inward rectifying potassium (Kir) channels. The initial treatment aims to treat potentially life-threatening cardiac arrhythmias caused by severe hypokalemia. This can be done with potassium substitution and nonselective beta-blockers, being aware of the potential of rebound hyperkaliemia. Definitive treatment consists of avoiding triggers and correcting the hyperthyroid state with antithyroid drugs, radioactive iodine, or thyroidectomy. Once patients are, permanently euthyroid complete remission of the paralytic attacks usually occurs. We present a case of a 37-year-old male with diffuse muscle weakness after surgery. A new diagnosis of thyrotoxic periodic paralysis was made in the emergency department. This review summarizes the epidemiology, clinical manifestations, pathogenesis, diagnostics, and treatment of TPP.
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Wouters et al. (2023) conducted a case report in Thyrotoxic periodic paralysis (n=1). Potassium chloride and magnesium sulfate was evaluated on Normalization of serum potassium and improvement in muscle strength. Intravenous potassium and magnesium supplementation rapidly normalized potassium levels and resolved muscle weakness in a patient with post-operative thyrotoxic periodic paralysis.
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