Case Report: A Patient with Suspicious of Thyrotoxic Periodic Paralysis

Abstract

Thyrotoxic periodic paralysis (TPP) is a reversible electrolyte disorder characterized by acute muscle weakness and hypokalemia associated with hyperthyroidism. This disorder is more common in Asian populations, especially in males. The age of the attack is between 20 and 40 years. Most of the patients who suffer from this condition do not show obvious signs and symptoms of hyperthyroidism, so there is often misdiagnosis. The goal for reporting this case to give aware about sign dan symptoms of TPP dan emergency management. We chose this case for review on the background that in such cases, the paralysis that occurs is seldom thought to be associated with thyroid disease, thus the interesting and unique nature of this case, is worth further discussion. Laboratory examination results show hyperthyroid conditions with Wayne’s index 23, Free Thyroxine (FT4) high, low Thyroid Stimulating Hormone (TSH), and potassium serum. The patient came with a weak condition so he couldn’t walk. Therapeutic therapy with 50 meq KCl drip, 3x10mg propranolol, and 3x100 mg PTU gave improved patient outcomes. After seven days admitted potassium serum would be normally with 4.71 mmol/L. In this case, early supplementation of KCL and correct diagnosis from anamnesis, physical examination, will give a good result.
 Keywords: Thyrotoxic periodic paralysis; electrolyte; reversible; hypokalemia