Thyrotoxic Periodic Paralysis With Graves' Disease: A Case Report

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Dec 9

PMID 39650991

Authors

Abin Thomas

Bilha Baby

Selin C Joy

Sreekrishnan T P

Gireesh Kumar K P

Affiliations

Soon will be listed here.

Abstract

One type of hypokalemic periodic paralysis that is associated with hyperthyroidism is called thyrotoxic periodic paralysis (TPP). TPP can be linked to any cause of hyperthyroidism, although Graves' disease is the most common cause. This sporadic variant of hypokalaemic periodic paralysis, thyrotoxic periodic paralysis, is characterized by rapid onset weakness in the proximal muscles. Due to their similar presentations, it is sometimes mistaken for familial periodic paralysis (FPP); however, biochemical tests and the presence of thyrotoxic characteristics can help distinguish the two conditions. Treatment options for this reversible illness include rapid potassium replacement and thyroid hormone normalization. To mitigate this potentially fatal complication, knowledge regarding the identification, prompt treatment, and avoidance of future episodes of TPP is crucial.

References

Hoshina Y, Setterquist H, McConnell T, Renner D . Thyrotoxic periodic paralysis presenting with quadriparesis and hyperreflexia. BMJ Case Rep. 2023; 16(12). PMC: 10759007. DOI: 10.1136/bcr-2023-256550. View

Zahir Hussain S, Al-Alousi S, Keshav L, Zahir Hussain A, Seenithamby K . A Thyrotoxic Periodic Paralysis Case Study: From Weakness to Wellness. Cureus. 2023; 15(10):e47820. PMC: 10631774. DOI: 10.7759/cureus.47820. View

Nicole S, Lory P . New Challenges Resulting From the Loss of Function of Na1.4 in Neuromuscular Diseases. Front Pharmacol. 2021; 12:751095. PMC: 8521073. DOI: 10.3389/fphar.2021.751095. View

Chang C, Cheng C, Sung C, Chiueh T, Lee C, Chau T . A 10-year analysis of thyrotoxic periodic paralysis in 135 patients: focus on symptomatology and precipitants. Eur J Endocrinol. 2013; 169(5):529-36. PMC: 3789562. DOI: 10.1530/EJE-13-0381. View

Lattouf A, Alhamss S, Kiani A, Solanki N, Younes N . Thyrotoxic Periodic Paralysis, an Unusual Presentation of Paralysis After Spinal Surgery: A Case Report. Cureus. 2024; 16(3):e55822. PMC: 10999753. DOI: 10.7759/cureus.55822. View

Barahona M, Vinagre I, Sojo L, Cubero J, Perez A . Thyrotoxic periodic paralysis: a case report and literature review. Clin Med Res. 2009; 7(3):96-8. PMC: 2757433. DOI: 10.3121/cmr.2009.816. View

Lin S . Thyrotoxic periodic paralysis. Mayo Clin Proc. 2005; 80(1):99-105. DOI: 10.1016/S0025-6196(11)62965-0. View

Ober K . Thyrotoxic periodic paralysis in the United States. Report of 7 cases and review of the literature. Medicine (Baltimore). 1992; 71(3):109-20. DOI: 10.1097/00005792-199205000-00001. View

Karndumri K, Thewjitcharoen Y, Chatchomchuan W, Porramatikul S, Krittiyawong S, Wanothayaroj E . Impact of first-line treatment choice on long-term outcomes of hyperthyroid Graves' disease patients with thyrotoxic periodic paralysis. J Clin Transl Endocrinol. 2020; 21:100235. PMC: 7486682. DOI: 10.1016/j.jcte.2020.100235. View

10.

Petty L, Kaput K . Graves' Disease With Initial Presentation of Thyrotoxic Periodic Paralysis. Cureus. 2023; 15(11):e49524. PMC: 10752825. DOI: 10.7759/cureus.49524. View

11.

Hussain Y, Hookham J, Allahabadia A, Balasubramanian S . Epidemiology, management and outcomes of Graves' disease-real life data. Endocrine. 2017; 56(3):568-578. PMC: 5435772. DOI: 10.1007/s12020-017-1306-5. View

12.

Meseeha M, Parsamehr B, Kissell K, Attia M . Thyrotoxic periodic paralysis: a case study and review of the literature. J Community Hosp Intern Med Perspect. 2017; 7(2):103-106. PMC: 5473192. DOI: 10.1080/20009666.2017.1316906. View

13.

Lin S, Huang C . Mechanism of thyrotoxic periodic paralysis. J Am Soc Nephrol. 2012; 23(6):985-8. PMC: 3358768. DOI: 10.1681/ASN.2012010046. View

14.

Dembele M, Yalcouye A, Cissoko M, Cisse L, Guinto C, Landoure G . A rare case of thyrotoxic periodic paralysis revealing Graves' disease in a young Malian. Clin Case Rep. 2024; 12(2):e8527. PMC: 10884522. DOI: 10.1002/ccr3.8527. View

15.

Poudel R, Baral S, Adhikari S, Dhungana U, Pradhan A, Baral S . Thyrotoxic periodic paralysis: a rare cause of periodic paralysis - a case report. Ann Med Surg (Lond). 2023; 85(4):931-933. PMC: 10129284. DOI: 10.1097/MS9.0000000000000105. View

16.

Gadi F, Schueler T . Atypical Normokalemic Case of Thyrotoxic Periodic Paralysis in a Pediatric Patient. Cureus. 2024; 16(4):e57467. PMC: 11065321. DOI: 10.7759/cureus.57467. View