Wongraoprasert Somporn, Buranasupkajorn Patinut, Sridama Vitaya, Snabboon Thiti
Division of Endocrine and Metabolism, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Intern Med. 2007;46(17):1431-3. doi: 10.2169/internalmedicine.46.0044. Epub 2007 Sep 3.
We present a young Thai man who developed acute flaccid paralysis after receiving pulse methylprednisolone for chronic inflammatory demyelinating polyneuropathy. Hypokalemia from intracellular shift was confirmed by calculation of transtubular potassium gradient (TTKG). His muscle strength and serum potassium fully recovered with a small amount of potassium replacement. Graves' disease was subsequently diagnosed and treated with radioactive iodine. We suggest that acute paralysis after the use of steroids should raise a suspicion of thyrotoxic periodic paralysis (TPP). The potential mechanisms of steroid-induced TPP are discussed.
我们报告一名年轻泰国男子，其在接受脉冲式甲基强的松龙治疗慢性炎症性脱髓鞘性多发性神经病后出现急性弛缓性麻痹。通过计算肾小管钾梯度（TTKG）证实了因细胞内转移导致的低钾血症。通过少量补钾，他的肌肉力量和血清钾完全恢复。随后诊断出格雷夫斯病，并采用放射性碘进行治疗。我们建议，使用类固醇后出现的急性麻痹应怀疑为甲状腺毒症性周期性麻痹（TPP）。本文讨论了类固醇诱导TPP的潜在机制。
