Hannon M J, Behan L A, Agha A
Academic Department of Endocrinology, Beaumont Hospital/RCSI Medical School, Dublin 9, Ireland.
Ann Clin Biochem. 2009 Sep;46(Pt 5):423-5. doi: 10.1258/acb.2009.009012. Epub 2009 Jul 29.
Thyrotoxic periodic paralysis is a potentially fatal complication of hyperthyroidism, more common in Asian races, which is defined by a massive intracellular flux of potassium. This leads to profound hypokalaemia and muscle paralysis. Although the paralysis is temporary, it may be lethal if not diagnosed and treated rapidly, as profound hypokalaemia may induce respiratory muscle paralysis or cardiac arrest. The condition is often misdiagnosed in the west due to its comparative rarity in Caucasians; however it is now increasingly described in Caucasians and is also being seen with increasing frequency in western hospitals due to increasing immigration and population mobility. Here we describe the case of a patient with panhypopituitarism due to a craniopharyngioma, who developed thyrotoxic periodic paralysis due to excessive L-thyroxine replacement. This disorder has been described in Asian subjects but, to our knowledge, thyrotoxic periodic paralysis secondary to excessive L-thyroxine replacement has never been described in Caucasians.
甲状腺毒症性周期性瘫痪是甲状腺功能亢进症的一种潜在致命并发症，在亚洲种族中更为常见，其定义为大量钾离子向细胞内流动。这会导致严重低钾血症和肌肉麻痹。虽然麻痹是暂时的，但如果不迅速诊断和治疗可能会致命，因为严重低钾血症可能会诱发呼吸肌麻痹或心脏骤停。由于在白种人中相对罕见，这种疾病在西方常被误诊；然而，现在在白种人中对其描述越来越多，并且由于移民增加和人口流动性增大，在西方医院中也越来越常见。在此我们描述一例因颅咽管瘤导致全垂体功能减退的患者，该患者因过量左甲状腺素替代治疗而发生甲状腺毒症性周期性瘫痪。这种疾病在亚洲人群中已有描述，但据我们所知，白种人中从未有过因过量左甲状腺素替代治疗继发甲状腺毒症性周期性瘫痪的报道。
