J Korean Med Sci.  2012 Jul;27(7):822-826. 10.3346/jkms.2012.27.7.822.

Thyrotoxic Periodic Paralysis Associated with Transient Thyrotoxicosis Due to Painless Thyroiditis

Affiliations
  • 1Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea. pons71@hanmail.net
  • 2Medical Research Institute, Pusan National University, Busan, Korea.
  • 3Kim Yong Ki Internal Medicine Clinic, Busan, Korea.

Abstract

Thyrotoxic periodic paralysis (TPP) is a rare manifestation of hyperthyroidism characterized by muscle weakness and hypokalemia. All ethnicities can be affected, but TPP typically presents in men of Asian descent. The most common cause of TPP in thyrotoxicosis is Graves' disease. However, TPP can occur with any form of thyrotoxicosis. Up to our knowledge, very few cases ever reported the relationship between TPP and painless thyroiditis. We herein report a 25-yr-old Korean man who suffered from flaccid paralysis of the lower extremities and numbness of hands. The patient was subsequently diagnosed as having TPP associated with transient thyrotoxicosis due to painless thyroiditis. The paralytic attack did not recur after improving the thyroid function. Therefore, it is necessary that early diagnosis of TPP due to transient thyrotoxicosis is made to administer definite treatment and prevent recurrent paralysis.

Keyword

Thyrotoxic Hypokalemic Periodic Paralysis; Painless Thyroiditis; Thyrotoxicosis

MeSH Terms

Administration, Oral
Adult
Anti-Arrhythmia Agents/therapeutic use
Humans
Hypokalemic Periodic Paralysis/*diagnosis/drug therapy/etiology
Male
Organotechnetium Compounds/chemistry/diagnostic use
Potassium Chloride/therapeutic use
Propranolol/therapeutic use
Radiopharmaceuticals/diagnostic use
Thyroiditis/*complications/radiography/ultrasonography
Thyrotoxicosis/*diagnosis/etiology
Anti-Arrhythmia Agents
Organotechnetium Compounds
Radiopharmaceuticals
Propranolol
Potassium Chloride

Figure

  • Fig. 1 Ultrasound findings of the thyroid. (A) A gray scale showed a normal sized thyroid gland, and neither nodules nor lymphadenopathy was detected. (B) Power doppler image revealed decreased vascularity.

  • Fig. 2 A thyroid scan with Tc-99m revealed little or no uptake in the thyroid area compatible with painless thyroiditis.


Cited by  1 articles

Thyrotoxic hypokalemic periodic paralysis due to Graves’ disease in 2 adolescents
Jung Gi Roh, Kyu Jung Park, Hae Sang Lee, Jin Soon Hwang
Ann Pediatr Endocrinol Metab. 2019;24(2):133-136.    doi: 10.6065/apem.2019.24.2.133.


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