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病例报告:复发性低钾性周期性麻痹伴远端肾小管酸中毒(1型)及桥本甲状腺炎继发甲状腺功能减退症。

Case Report: Recurrent hypokalemic periodic paralysis associated with distal renal tubular acidosis (type 1) and hypothyroidism secondary to Hashimoto's thyroiditis.

作者信息

Meregildo-Rodríguez E Dante, Failoc-Rojas Virgilio E

机构信息

Servicio de Medicina Interna y emergencia, Hospital Regional Lambayeque, Lambayeque, Peru.

Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru.

出版信息

F1000Res. 2018 Jul 30;7:1154. doi: 10.12688/f1000research.15662.3. eCollection 2018.

Abstract

Hypokalemic periodic paralysis (HypoKPP) is characterized by transient episodes of flaccid muscle weakness. We describe the case of a teenaged boy with HypoKPP and hyperthyroidism due to Hashimoto's thyroiditis with initial manifestation of renal tubular acidosis. This combination is rare and little described previously in men. : A 17-year-old boy was admitted after three days of muscular weakness and paresthesia in the lower limbs with an ascending evolution, leading to prostration. Decreased strength was found in the lower limbs without a defined sensory level, reduced patellar and ankle reflexes. Positive antithyroid antibodies were found. He received hydration treatment, IV potassium and levothyroxine, with which there was a clinical improvement. Other examinations led to the diagnosis of type 1 renal tubular acidosis. : HypoKPP is a rare disorder characterized by acute episodes of muscle weakness. Type 1 renal tubular acidosis can occur as a consequence of thyroiditis, which is explained by the loss of potassium. This combination is unusually rare, and has not been described before in men. The etiopathogenesis of the disease as well as a dynamic explanation of what happened with the patient are discussed in this report.

摘要

低钾性周期性麻痹(HypoKPP)的特征是出现弛缓性肌无力的短暂发作。我们描述了一例患有HypoKPP和因桥本甲状腺炎导致的甲状腺功能亢进症的青少年男性病例,其最初表现为肾小管酸中毒。这种组合很罕见,之前在男性中鲜有报道。:一名17岁男孩在出现下肢肌无力和感觉异常三天后入院,症状呈上行性发展,最终导致全身无力。下肢肌力减弱但无明确的感觉平面,髌反射和踝反射减弱。抗甲状腺抗体呈阳性。他接受了补液治疗、静脉补钾和左甲状腺素治疗,临床症状有所改善。其他检查确诊为1型肾小管酸中毒。:HypoKPP是一种罕见的疾病,其特征为急性肌无力发作。1型肾小管酸中毒可能是甲状腺炎的结果,这可以用钾的流失来解释。这种组合异常罕见,之前在男性中未曾有过描述。本报告讨论了该疾病的发病机制以及对该患者病情发展的动态解释。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a996/6338241/cf335709c131/f1000research-7-19554-g0000.jpg

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