Hypokalemic Paralysis Complicated by Concurrent Hyperthyroidism and Chronic Alcoholism: A Case Report.

Abstract

Thyrotoxic periodic paralysis (TPP) is characterized by the presence of muscle paralysis, hypokalemia, and hyperthyroidism. We report the case of a young man with paralysis of the lower extremities, severe hypokalemia, and concurrent hyperthyroidism. TPP was suspected; therefore, treatment consisting of judicious potassium (K+) repletion and β-blocker administration was initiated. However, urinary K+ excretion rate, as well as refractoriness to treatment, was inconsistent with TPP. Chronic alcoholism was considered as an alternative cause of hypokalemia, and serum K+ was restored through vigorous K repletion and the addition of K+ -sparing diuretics. The presence of thyrotoxicosis and hypokalemia does not always indicate a diagnosis of TPP. Exclusion of TPP can be accomplished by immediate evaluation of urinary K+ excretion, acid-base status, and the amount of potassium chloride required to correct hypokalemia at presentation.

• Authors: Ming-Hsien Tsai, Shih-Hua Lin, Jyh-Gang Leu, Yu-Wei Fang
• Journal: Medicine (Medicine (Baltimore)) Vol. 94 Issue 39 Pg. e1689 (Sep 2015) ISSN: 1536-5964 [Electronic] United States
• PMID: 26426670 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Alcoholism (complications, diagnosis)
• Chronic Disease
• Humans
• Hyperthyroidism (complications, diagnosis)
• Hypokalemic Periodic Paralysis (complications, diagnosis)
• Male