thyrotoxic hypokalemic periodic paralysis
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Etiology
- can occur in association with any cause of hyperthyroidism, but is most commonly associated with Graves disease
Epidemiology
- occurs in Mexican or Asian men
Pathology
- hyperthyroidsm
- muscle disorder
Genetics
Clinical manifestations
- recurrent episodes of acute muscular weakness of all four extremities, varying in severity from paresis to complete paralysis
- attacks are triggered by ingestion of a high carbohydrateload or strenuous physical activity followed by a period of rest
- palpitations, trembling, insomnia[5] (case report)*
- goiter may be present[5]
- thyrotoxicosis
* image & videos[5]
Laboratory
- serum K+: hypokalemia during a thyrotoxic state
- thyroid function tests: evidence of hyperthyroidism
- serum phosphate may be low[5]
Differential diagnosis
- similar to hereditary hypokalemic periodic paralysis, except that hyperthyroidism is an absolute requirement
Management
- resolves with treatment of hyperthyroidism[4]
More general terms
References
- ↑ OMIM https://mirror.omim.org/entry/188580
- ↑ OMIM https://mirror.omim.org/entry/613239
- ↑ Falhammar H, Thoren M, Calissendorff J. Thyrotoxic periodic paralysis: clinical and molecular aspects. Endocrine. 2013 Apr;43(2):274-84. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22918841
- ↑ 4.0 4.1 Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022 - ↑ 5.0 5.1 5.2 5.3 5.4 Fralick M, Sarma S. Images in Clinical Medicine Thyrotoxic Periodic Paralysis. N Engl J Med 2021. May 8 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33983691 https://www.nejm.org/doi/full/10.1056/NEJMicm2030770