Insights into Thyrotoxic Periodic Paralysis: A Comprehensive Case Study of a Rare Thyrotoxic Manifestation

  • Arun Bargali Resident, Department of Internal Medicine, Maulana Azad Medical College and Lok Nayak Hospital.
  • Princy Poonam Resident, Department of Internal Medicine, Maulana Azad Medical College and Lok Nayak Hospital.
  • Manisha V Prabhu Resident, Department of Internal Medicine, Maulana Azad Medical College and Lok Nayak Hospital.
  • Grisha Maich Resident, Department of Internal Medicine, Maulana Azad Medical College and Lok Nayak Hospital.
  • Rajam Iyer Bhavana 5Resident, Department of Internal Medicine, Maulana Azad Medical College and Lok Nayak Hospital.
  • Rashmi Mishra Assistant Professor, Department of Internal Medicine, Maulana Azad Medical College and Lok Nayak Hospital.
Keywords: Thyrotoxicosis, Periodic Paralysis, Hypokalemia, Quadriparesis

Abstract

Thyrotoxic periodic paralysis (TPP) is a rare and potentially lethal complication of hyperthyroidism characterised by sudden onset paralysis associated with hypokalemia. We report a case of a 38-year-old male who presented with a history of multiple episodes of vomiting followed by sudden onset quadriparesis. Subsequently, he developed respiratory distress and was intubated. On examination, he was irritable with tachycardia and tachypnea with a temperature of 102 °F and BP of 160/78 mm Hg. Thyroid profile was suggestive of primary hyperthyroidism with TSH of 0.015 mIU/L, fT3 of 20.8 pmol/L and fT4 of 58.6 pmol/L. Serum potassium was 1.7 mmol/L. MRI brain was normal. A thyroid scan showed an enlarged thyroid with increased tracer uptake. TRAb was positive. The patient was diagnosed with hypokalemic periodic paralysis secondary to thyrotoxicosis and was managed with propylthiouracil along with a saturated solution of potassium iodide with a high dose
of beta blockers, IV fluids with potassium supplementation, antibiotics and steroids. The patient improved clinically and was discharged on antithyroid medication.

How to cite this article:
Bargali A, Poonam P, Parbhu V M, Maich G,
Bhavana l R, Mishra R . Insights into Thyrotoxic
Periodic Paralysis: A Comprehensive Case Study
of a Rare Thyrotoxic Manifestation J Adv Res
Med 2023; 10(3): 1-4

DOI: https://doi.org/10.24321/2349.7181.202312

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Published
2023-10-31