Kannan Lakshmi, Kim Young Nam
Department of Internal Medicine, Einstein Medical Center, Philadelphia, Pennsylvania, USA.
Department of Internal Medicine and Endocrinology, Einstein Medical Center, Philadelphia, Pennsylvania, USA.
N Am J Med Sci. 2015 Mar;7(3):119-21. doi: 10.4103/1947-2714.153924.
Thyrotoxic periodic paralysis (TPP) is a potentially life-threatening complication of hyperthyroidism that is underdiagnosed and frequently missed. It is relatively common in Asian men with Graves' disease. TPP attacks are frequently associated with hypokalemia.
Here we report a non-Asian female patient with Graves' disease, who presented with flaccid paralysis associated with an episode of subacute thyroiditis (SAT). Interestingly, she was found to have low normal potassium levels in the serum during the initial attack despite which she continues to require low dose potassium supplementation to prevent recurrent TPP attacks. Unique features in our patient include her gender, ethnicity, time lag between initial diagnosis of Graves' disease, and the development of TPP and borderline low potassium levels, with the continuous need for prophylactic potassium supplementation.
It is important to be aware of this complication of hyperthyroidism that has a dramatic yet variable presentation, but is readily amenable to therapy.
甲状腺毒症性周期性瘫痪（TPP）是甲状腺功能亢进症的一种潜在危及生命的并发症，目前诊断不足且经常被漏诊。它在患有格雷夫斯病的亚洲男性中相对常见。TPP发作常与低钾血症相关。
我们在此报告一名患有格雷夫斯病的非亚洲女性患者，她出现了与亚急性甲状腺炎（SAT）发作相关的弛缓性麻痹。有趣的是，在初次发作时发现她血清钾水平略低于正常范围，尽管如此，她仍需要低剂量补钾以预防TPP复发。我们患者的独特特征包括她的性别、种族、格雷夫斯病初次诊断与TPP发生之间的时间间隔，以及临界低血钾水平，并且持续需要预防性补钾。
认识到这种甲状腺功能亢进症的并发症很重要，它表现显著但多变，但易于治疗。
