Key result
Pulse methylprednisolone linked to acute flaccid paralysis and severe hypokalemia in thyrotoxic periodic paralysis.
Case Report (n=1)
No
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Pulse corticosteroids may trigger thyrotoxic periodic paralysis in susceptible patients; this single case leaves open causality and generalizability.
We present a young Thai man who developed acute flaccid paralysis after receiving pulse methylprednisolone for chronic inflammatory demyelinating polyneuropathy. Hypokalemia from intracellular shift was confirmed by calculation of transtubular potassium gradient (TTKG). His muscle strength and serum potassium fully recovered with a small amount of potassium replacement. Graves' disease was subsequently diagnosed and treated with radioactive iodine. We suggest that acute paralysis after the use of steroids should raise a suspicion of thyrotoxic periodic paralysis (TPP). The potential mechanisms of steroid-induced TPP are discussed.
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Wongraoprasert et al. (2007) conducted a case report in Thyrotoxic periodic paralysis (n=1). Pulse methylprednisolone was evaluated on Development of acute flaccid paralysis and hypokalemia. A 23-year-old man developed acute flaccid paralysis and severe hypokalemia due to thyrotoxic periodic paralysis four hours after receiving a 1 g infusion of pulse methylprednisolone.
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