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甲状腺毒症性周期性瘫痪:美国的多样性

Thyrotoxic periodic paralysis: diversity in America.

作者信息

Patel Hetain, Wilches Lina Vanessa, Guerrero Jorge

机构信息

Division of Critical Care and Pulmonary Diseases, Florida Hospital Orlando, Orlando, Florida.

出版信息

J Emerg Med. 2014 Jun;46(6):760-2. doi: 10.1016/j.jemermed.2013.08.104. Epub 2013 Dec 5.

Abstract

BACKGROUND

Thyrotoxic periodic paralysis (TPP) is a potentially life-threatening complication of thyrotoxicosis, characterized by hypokalemia and muscle paralysis.

OBJECTIVE

TPP, although becoming more prevalent in western countries, is still often not recognized due to lack of familiarity and the subtlety of the thyrotoxic symptoms. Early recognition by emergency physicians can prevent potential mortality.

CASE REPORT

A 23-year-old Vietnamese male presented with a 2-h history of complete flaccid quadriplegia and chest tightness. Electrolyte studies revealed a critical potassium level of 1.4 mmol/L. The patient was admitted to the intensive care unit where further workup revealed thyrotoxicosis and the patient was subsequently diagnosed with TPP.

CONCLUSIONS

TPP should always be considered as a differential in patients, especially in young males of Asian descent with lower-limb paralysis or weakness. We present this case, followed by a review of the literature.

摘要

背景

甲状腺毒症性周期性瘫痪(TPP)是甲状腺毒症的一种潜在危及生命的并发症,其特征为低钾血症和肌肉麻痹。

目的

TPP在西方国家虽日益普遍,但由于对甲状腺毒症症状缺乏了解且症状不明显,往往仍未被识别。急诊科医生的早期识别可预防潜在的死亡。

病例报告

一名23岁的越南男性因完全性弛缓性四肢瘫和胸闷2小时前来就诊。电解质检查显示血钾水平危急,为1.4 mmol/L。患者被收入重症监护病房,进一步检查发现甲状腺毒症,随后被诊断为TPP。

结论

对于患者,尤其是患有下肢瘫痪或无力的亚洲裔年轻男性,应始终将TPP视为鉴别诊断之一。我们呈现此病例,并对文献进行综述。

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