Tachamo Niranjan, Lohani Saroj, Nazir Salik, Juliano Noelle
Department of Internal Medicine, Reading Health System, West Reading, Pennsylvania, USA.
Reading Hospital and Medical Center, Reading, Pennsylvania, USA.
BMJ Case Rep. 2017 Jan 30;2017:bcr2016218951. doi: 10.1136/bcr-2016-218951.
Thyrotoxic periodic paralysis is a potentially life-threatening condition associated with recurrent episodes of muscle weakness and hypokalaemia due to hyperthyroidism. Diagnosis is often delayed or misdiagnosed due to its rarity in the western world and subtle features of hyperthyroidism on initial presentation. Here we present the case of a 25-year-old man who presented to the emergency department (ED) with sudden onset weakness of bilateral upper and lower extremities. His labs revealed hypokalaemia with elevated T4 and suppressed thyroid-stimulating hormone and he was diagnosed with thyrotoxic periodic paralysis. He was treated with potassium repletion, atenolol and methimazole with complete reversal of his paralysis within the next day. Unfortunately, he failed to keep the follow-up appointment after discharge, ran out of his methimazole and landed up in the ED again.
甲状腺毒症性周期性瘫痪是一种潜在的危及生命的疾病，与甲状腺功能亢进导致的反复发作的肌无力和低钾血症有关。由于其在西方世界较为罕见，且初次就诊时甲状腺功能亢进的特征不明显，诊断往往会延迟或误诊。在此，我们报告一例25岁男性病例，该患者因双侧上下肢突然无力就诊于急诊科。他的实验室检查显示低钾血症，T4升高，促甲状腺激素降低，被诊断为甲状腺毒症性周期性瘫痪。给予补钾、阿替洛尔和甲巯咪唑治疗后，次日其瘫痪完全恢复。不幸的是，他出院后未按时复诊，甲巯咪唑用完后再次就诊于急诊科。
