Khadka Sabina, K C Indu, Rayamajhi Rabindra Jang, Dawadi Pravakar, Budhathoki Pravash
Nepalese Army Institute of Health Sciences, Sanobharyang, Kathmandu, Nepal.
Department of Medicine, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2019 Nov-Dec;57(220):460-463. doi: 10.31729/jnma.4763.
Thyrotoxic periodic paralysis is rare complication of hyperthyroidism characterized by the sudden onset of hypokalemia and muscle paralysis. It is typically present in young Asian males. There are very few literatures regarding the occurrence of thyrotoxic hypokalemic periodic paralysis in Nepal. We reported a case of a 35-year-old male presented with the chief complaints of weakness of all four limbs of 1 day duration. He was diagnosed as a case of hyperthyroidism in the past, received treatment for 6 months and left medications on his own 6 months ago. Evaluation during admission revealed severe hypokalemia with serum potassium level 1.3mEq/l and high serum Triiodothyronine (>20.00µg/L) and low serum Thyroid Stimulating Hormone (<0.01µg/L). Potassium supplements resolved muscle weakness and the patient was restarted with anti-thyroid drugs. Hence, hypokalemic paralysis is a reversible cause of paralysis and high index of suspicion as well as timely interventions are required to prevent potential harm. Keywords: hyperthyroidism; hypokalemia; muscle paralysis; thyrotoxic periodic paralysis.
甲状腺毒症性周期性瘫痪是甲状腺功能亢进症的一种罕见并发症，其特征为低钾血症和肌肉麻痹的突然发作。它通常见于年轻的亚洲男性。关于尼泊尔甲状腺毒症性低钾性周期性瘫痪的发生，相关文献非常少。我们报告了一例35岁男性病例，其主要症状为四肢无力，持续1天。他过去被诊断为甲状腺功能亢进症，接受了6个月的治疗，6个月前自行停药。入院时的评估显示严重低钾血症，血清钾水平为1.3mEq/l，血清三碘甲状腺原氨酸水平高（>20.00µg/L），血清促甲状腺激素水平低（<0.01µg/L）。补充钾后肌肉无力症状缓解，患者重新开始服用抗甲状腺药物。因此，低钾性瘫痪是一种可逆转的瘫痪原因，需要高度怀疑并及时干预以防止潜在危害。关键词：甲状腺功能亢进症；低钾血症；肌肉麻痹；甲状腺毒症性周期性瘫痪
