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一名白人男性因双侧下肢瘫痪就诊于急诊科。

Bilateral Lower Extremity Paralysis in a Caucasian Male Presenting to the Emergency Department.

作者信息

Bao Yicheng K, Ganesan Vishwanath C, Rapp Richard, Bao Shunzhong S

机构信息

University of Missouri-Kansas City School of Medicine, USA.

Little Rock Diagnostic Clinic, USA.

出版信息

Case Rep Emerg Med. 2018 May 15;2018:5740509. doi: 10.1155/2018/5740509. eCollection 2018.

Abstract

Reported is a case of a 39-year-old Caucasian man who presented to the emergency department with sudden onset bilateral lower extremity paralysis after consuming a large amount of carbohydrates and alcohol. A CT, MRI, and lumbar puncture were performed with negative results; lab results showed hyperthyroidism and hypokalemia. The patient was diagnosed with thyrotoxic periodic paralysis. In a patient presenting with sudden onset paralysis and hypokalemia, the emergency physician should include thyrotoxic periodic paralysis in the differential diagnosis and focus on treating and working up the hypokalemia instead of the paralysis.

摘要

报告了一例39岁的高加索男性病例,该患者在大量摄入碳水化合物和酒精后突然出现双侧下肢麻痹,前往急诊科就诊。进行了CT、MRI和腰椎穿刺,结果均为阴性;实验室检查结果显示甲状腺功能亢进和低钾血症。该患者被诊断为甲状腺毒症性周期性麻痹。对于突然出现麻痹和低钾血症的患者,急诊医生应将甲状腺毒症性周期性麻痹纳入鉴别诊断,并着重治疗和检查低钾血症而非麻痹。

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本文引用的文献

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Thyrotoxic periodic paralysis: a case study and review of the literature.甲状腺毒症性周期性瘫痪:病例研究及文献综述
J Community Hosp Intern Med Perspect. 2017 Jun 6;7(2):103-106. doi: 10.1080/20009666.2017.1316906. eCollection 2017 Mar.
3
Thyrotoxic periodic paralysis: clinical challenges.甲状腺毒症性周期性瘫痪:临床挑战
J Thyroid Res. 2014;2014:649502. doi: 10.1155/2014/649502. Epub 2014 Feb 20.
4
Thyrotoxic periodic paralysis: clinical and molecular aspects.甲状腺毒症性周期性瘫痪:临床与分子方面。
Endocrine. 2013 Apr;43(2):274-84. doi: 10.1007/s12020-012-9777-x. Epub 2012 Aug 24.
5
Mechanism of thyrotoxic periodic paralysis.甲状腺毒性周期性瘫痪的机制。
J Am Soc Nephrol. 2012 Jun;23(6):985-8. doi: 10.1681/ASN.2012010046. Epub 2012 Mar 29.

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