Harrogate Suzanne R, Mills Edouard, Qureshi Asjid, de Wolff Jacob F
BMBCh BA (Oxon), Academic Foundation Year 2 Doctor, Imperial College Healthcare NHS Trust, The Bays, South Wharf Road, St Mary's Hospital, London.
MRCP, ST5 Endocrinology/GIM, Imperial College Healthcare NHS Trust, The Bays, South Wharf Road, St Mary's Hospital, London.
Acute Med. 2016;15(4):209-211.
A previously healthy 35-year old man presented to hospital with acute leg weakness following an alcohol binge. On assessment, tachycardia, urinary retention and bilateral upper and lower limb proximal weakness with preserved peripheral power were noted. Biochemistry revealed marked hypokalaemia, which responded to intravenous replacement, and biochemical thyrotoxicosis, leading to the diagnosis of Thyrotoxic Periodic Paralysis (TPP). Anti-thyroid therapy and beta-blockers were commenced and his neurological symptomatology resolved as he became progressively euthyroid. TPP is a rare acquired subtype of hypokalaemic periodic paralysis, typically causing proximal muscle weakness associated with thyrotoxicosis. It is most common in young Asian males. Acute treatment requires cautious oral potassium supplementation, beta-blockade, and anti-thyroid therapy. TPP is prevented by maintaining euthyroidism; otherwise recurrence is likely.
一名35岁既往健康的男性在一次酗酒狂欢后因急性腿部无力入院。评估时，发现心动过速、尿潴留以及双侧上肢和下肢近端无力但外周肌力保留。生化检查显示明显低钾血症，经静脉补钾后有所缓解，同时存在生化性甲状腺毒症，从而诊断为甲状腺毒症性周期性瘫痪（TPP）。开始给予抗甲状腺治疗和β受体阻滞剂，随着甲状腺功能逐渐恢复正常，他的神经症状也得以缓解。TPP是低钾性周期性瘫痪一种罕见的后天性亚型，通常导致与甲状腺毒症相关的近端肌无力。在年轻亚洲男性中最为常见。急性治疗需要谨慎口服补钾、β受体阻滞剂治疗以及抗甲状腺治疗。通过维持甲状腺功能正常来预防TPP；否则很可能复发。
