Thyrotoxic periodic paralysis presenting in an African-American teenage male: case report

Joshua Glass,Jennifer Osipoff

doi:10.1186/s13633-020-00077-3

Joshua Glass, Jennifer Osipoff

Open Access

https://doi.org/10.1186/s13633-020-00077-3

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Abstract

BackgroundThyrotoxic periodic paralysis is a rare complication of hyperthyroidism and is associated with hypokalemia and muscle paralysis. This condition is most commonly seen in Asian men.Case presentationWe report on a 14-year-old African American male with Graves’ disease and intermittent asthma who presented with bilateral leg weakness. The patient demonstrated signs of thyrotoxicosis and laboratory evaluation revealed hypokalemia and hyperthyroidism. Following the administration of potassium supplementation clinical status improved and the patient was discharged home on a high dose of methimazole and propranolol. At a 6-month follow up visit, he was found to be clinically euthyroid and demonstrated no signs of hyperthyroidism or muscle weakness.ConclusionChildren presenting with weakness and hypokalemia should be investigated for thyroid dysfunction. Correction of hypokalemia improves acute presentation, but the patient will remain at risk for paralysis until euthyroid state is achieved.

Highlights

Thyrotoxic periodic paralysis is a rare complication of hyperthyroidism and is associated with hypokalemia and muscle paralysis
Hypokalemic thyrotoxic periodic paralysis (HTPP) occurs as a rare complication of hyperthyroidism. It is associated with a significant intracellular shift of potassium and manifests itself clinically by hypokalemia and muscle paralysis
We present a case of hypokalemic thyrotoxic periodic paralysis in an African-American teenage male diagnosed previously with Graves’ disease

Summary

Conclusion

This case highlights the challenges faced in the diagnosis and treatment of HTPP in a young. African-American male who suffered from Graves’ disease as well as pulmonary asthma. HTPP remains a rare entity in non-Asian populations and early diagnosis helps to prevent adverse outcomes.

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