Case Report on Endocrine Induced Paralysis - " Unraveling The Impact of Thyrotoxicosis On Potassium Homeostasis."

Thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism, marked by episodes of muscle weakness and hypokalaemia. Although it predominantly affects young Asian men, it can also occur in females and individuals from non-Asian ethnic groups. TPP is a treatable form of hypokalaemic periodic paralysis and can often be the first indication of thyrotoxicosis. Triggers such as a high-carbohydrate diet, strenuous exercise, emotional stress, and steroid use can provoke TPP attacks. During an acute episode, the key diagnostic indicators are hypokalaemia along with elevated levels of thyroxine (T4) and triiodothyronine (T3). Treatment consists of two phases: promptly correcting hypokalaemia to reverse the paralysis, followed by measures to prevent future attacks by restoring a euthyroid state. CASE PRESENTATION: A 30 year old male presented to the hospital with sudden onset of weaknessin both upper limbs and lower limbs since one day with history of similar complaints 2 years ago. On evaluation, he was found to have severe hypokalaemia (K-1.7meq/l) His TSH levels were 0.005miu/ml, Free T3 was18.34 pg/ml and Free T4 was 5.1ng/dl. He was treated with intravenous potassium and anti-thyroid medications, Carbimazole and Propranolol. CONCLUSION: Early diagnosis of thyrotoxic periodic paralysis is crucial to prevent complications like fatal arrhythmias and ensure effective treatment. Clinicians should consider TPP in cases of acute paralysis with hypokalaemia and promptly evaluate thyroid function.