Ann Pediatr Endocrinol Metab.  2014 Sep;19(3):169-173. 10.6065/apem.2014.19.3.169.

A case of thyrotoxic periodic paralysis as initial manifestation of Graves' disease in a 16-year-old Korean adolescent

• Jung SY
• Song KC
• Shin JI
• Chae HW
• Kim HS
• Kwon AR

• KMID: 2134086
• DOI: http://doi.org/10.6065/apem.2014.19.3.169

Abstract

Thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism, with recurrent muscle paralysis and hypokalemia that are caused by an intracellular shift of potassium. TPP is relatively common in Asian males, but is extremely rare in children and adolescents, even for those of Asian descent. We describe a 16-year-old Korean adolescent presenting with a two-week history of episodic leg weakness in the morning. He showed sinus tachycardia, lower leg weakness, and hypokalemia. Thyroid function test showed hyperthyroidism, and thyroid ultrasonography revealed a diffuse enlarged thyroid with increased vascularity, consistent with Graves' disease. He was treated with beta-adrenergic blocker and antithyroid drugs. He has been symptom free for one year, as his hyperthyroidism has been controlled well with antithyroid drugs. TPP should be considered in children and adolescents with acute paralysis of the lower extremities and hypokalemia.

Keyword

Thyrotoxic periodic paralysis; Graves' disease; Adolescent; Korean

MeSH Terms

Adolescent*
Antithyroid Agents
Asian Continental Ancestry Group
Child
Graves Disease*
Humans
Hyperthyroidism
Hypokalemia
Leg
Lower Extremity
Male
Paralysis*
Potassium
Tachycardia, Sinus
Thyroid Function Tests
Thyroid Gland
Ultrasonography
Antithyroid Agents
Potassium

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