Department of Endocrinology, Command Hospital, Lucknow, Uttar Pradesh, India.
Department of Endocrinology, Command Hospital, Kolkata, West Bengal &, India.
Indian J Med Res. 2020 Jan;151(1):42-46. doi: 10.4103/ijmr.IJMR_335_18.
BACKGROUND & OBJECTIVES: Thyrotoxic periodic paralysis (TPP) is an endocrine emergency presenting with acute-onset flaccid paralysis in a patient having thyrotoxicosis accompanied by hypokalaemia. This study was conducted to evaluate the clinical profile of patients with TPP presenting to three centres in India.
This retrospective, observational study was conducted at three tertiary care Armed Forces medical centres, located at Lucknow, Kolkata and Delhi. The history, clinical features, treatment details and outcomes were evaluated.
Of the 244 patients with thyrotoxicosis, 15 were diagnosed with TPP and included in the study. These 15 patients (14 male and 1 female) had 32 episodes of TPP which were analyzed. The mean age was 30.2±6.2 yr (range: 21-39), and overt thyrotoxicosis was seen in all patients except one who had subclinical hyperthyroidism. Graves' disease was the most common cause of thyrotoxicosis (13/15) and the remaining two patients had subacute thyroiditis and gestational thyrotoxicosis. Hypokalaemia (serum potassium <3.5 mmol/l) was seen in 12 patients, and the mean serum potassium was 3.2±0.9 mmol/l (range: 2.1-4.9). All patients had flaccid weakness, predominantly involving the lower limb with no bulbar, respiratory or cranial nerve involvement. The average duration of paralysis was 10.6±5.7 h (range: 3-28 h).
INTERPRETATION & CONCLUSIONS: Our study demonstrated an early age of presentation and presence of clinical and biochemical thyrotoxicosis in majority of patients with TPP. Hypokalaemia may not always be evident in patients with TPP.
甲状腺毒症周期性瘫痪（TPP）是一种内分泌急症，表现为甲状腺毒症伴低钾血症的患者突发弛缓性瘫痪。本研究旨在评估印度三家中心 TPP 患者的临床特征。
这是一项在印度三家三级保健武装部队医疗中心进行的回顾性观察性研究。评估了病史、临床特征、治疗细节和结局。
在 244 例甲状腺毒症患者中，有 15 例诊断为 TPP 并纳入研究。这 15 名患者（14 名男性和 1 名女性）共发生 32 次 TPP 发作，对其进行了分析。平均年龄为 30.2±6.2 岁（范围：21-39 岁），除了一名患者为亚临床甲状腺功能亢进症外，所有患者均有显性甲状腺毒症。Graves 病是甲状腺毒症最常见的原因（13/15），其余两名患者患有亚急性甲状腺炎和妊娠期甲状腺毒症。低钾血症（血清钾<3.5mmol/l）见于 12 例患者，平均血清钾为 3.2±0.9mmol/l（范围：2.1-4.9）。所有患者均有弛缓性无力，主要累及下肢，无球麻痹、呼吸或颅神经受累。瘫痪的平均持续时间为 10.6±5.7 小时（范围：3-28 小时）。
我们的研究表明，TPP 患者的发病年龄较早，且大多数患者存在临床和生化甲状腺毒症。TPP 患者的低钾血症可能并不总是明显。
