Wi Jung-Kook, Lee Hong Joo, Kim Eun Young, Cho Joo Hee, Chin Sang Ouk, Rhee Sang Youl, Moon Ju-Young, Lee Sang-Ho, Jeong Kyung-Hwan, Ihm Chun-Gyoo, Lee Tae-Won
Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea.
Electrolyte Blood Press. 2012 Dec;10(1):18-25. doi: 10.5049/EBP.2012.10.1.18. Epub 2012 Dec 31.
Recognizing the underlying causes of hypokalemic paralysis seems to be essential for the appropriate management of affected patients and their prevention of recurrent attacks. There is, however, a paucity of documented reports on the etiology of hypokalemic paralysis in Korea. We retrospectively analyzed 34 patients with acute flaccid weakness due to hypokalaemia who were admitted during the 5-year study period in order to determine the spectrum of hypokalemic paralysis in Korea and to identify the differences in clinical parameters all across the causes of hypokalemic paralysis. We divided those 34 patients into 3 groups; the 1(st) group, idiopathic hypokalemic periodic paralysis (HPP), the 2(nd), thyrotoxic periodic paralysis (TPP), and the 3rd group, secondary hypokalemic paralysis (HP) without TPP. Seven of the patients (20.6%) were diagnosed as idiopathic HPP considered the sporadic form, and 27 patients (79.4%) as secondary HP. Among the patients diagnosed as secondary HP, 16 patients (47.1%) had TPP. Patients of secondary hypokalemic paralysis without TPP required a longer recovery time compared with those who had either idiopathic HPP or TPP. This is due to the fact that patients of secondary HP had a significantly negative total body potassium balance, whereas idiopathic HPP and TPP were only associated with intracellular shift of potassium. Most of the TPP patients included in our study had overt thyrotoxicosis while 3 patients had subclinical thyrotoxicosis. This study shows that TPP is the most common cause of hypokalemic paralysis in Korea. And we suggest that doctors should consider the presence of TPP in patients of hypokalemic paralysis even if they clinically appear to be euthyroid state.
认识低钾性麻痹的潜在病因似乎对于妥善治疗受影响患者并预防其复发至关重要。然而，韩国关于低钾性麻痹病因的文献报道较少。我们回顾性分析了在5年研究期间因低钾血症入院的34例急性弛缓性肌无力患者，以确定韩国低钾性麻痹的范围，并找出低钾性麻痹所有病因在临床参数上的差异。我们将这34例患者分为3组：第1组为特发性低钾性周期性麻痹（HPP），第2组为甲状腺毒症性周期性麻痹（TPP），第3组为无TPP的继发性低钾性麻痹（HP）。7例患者（20.6%）被诊断为散发性特发性HPP，27例患者（79.4%）为继发性HP。在诊断为继发性HP的患者中，16例（47.1%）患有TPP。与患有特发性HPP或TPP的患者相比，无TPP的继发性低钾性麻痹患者恢复时间更长。这是因为继发性HP患者总体钾平衡显著为负，而特发性HPP和TPP仅与钾的细胞内转移有关。我们研究中的大多数TPP患者有明显的甲状腺毒症，而3例患者有亚临床甲状腺毒症。这项研究表明，TPP是韩国低钾性麻痹最常见的病因。我们建议医生即使在低钾性麻痹患者临床看似甲状腺功能正常的情况下，也应考虑TPP的存在。
