Abstract
Thyrotoxic periodic paralysis is a disease characterized by recurrent episodes of paralysis and hypokalemia during a thyrotoxic state. Thyrotoxic periodic paralysis is a common complication of hyperthyroidism in Asian populations, but can affect other ethnic groups as well. Due to population mobility, Thyrotoxic periodic paralysis is increasingly common in Western countries. Early diagnosis and prompt treatment of the thyrotoxic state and potassium supplementation prevent life-threatening complications associated with hypokalemia and muscle weakness. We present a young Turkish man who developed acute flaccid paralysis after receiving pulse prednisolone therapy for treatment of Pityriasis versicolor. His muscle strength and serum potassium fully recovered after potassium replacement and treatment of the thyrotoxic state which was a consequence of underlying Graves’ disease.
Highlights
Acute tetraparesis is a neurological emergency which requires immediate diagnostic workup
The skin changes were diagnosed as Pityriasis versicolor. This case report highlights an unusual presentation of a patient with symptoms consistent with those seen in patients with an aortic dissection, where further diagnostics revealed an initial manifestation of thyrotoxic periodic paralysis (TPP) which was induced by intravenous pulse prednisolone therapy
TPP is characterized by recurrent, transient episodes of muscle weakness to complete flaccid paralysis in the setting of a low serum potassium level and biochemical evidence of thyrotoxicosis, low thyroidea stimulating hormone (TSH) along with elevated free thyroxine (fT4) or free trijodthyronine (fT3), as observed in our patient
Summary
Acute tetraparesis is a neurological emergency which requires immediate diagnostic workup. When the patient arrived at the emergency department the blood pressure was 110/60 mmHg and the heart rate was 120 bpm. On his trunk and arms were confluating erythematous patches which appeared 3 days ago. Beside nephrectomy after traumatic kidney rupture in childhood no relevant previous disease was present and no previous muscle weakness was noticed He reported that he consulted his GP the same morning for treatment of the erythematous patches. After administration of 30 mmol of potassium chloride within 3 hours, the patient got serious cardiac bradyarrhythmias followed by an asystolia which required mechanical reanimation for a short period of time.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
