van Bokhorst Querijn N E, Krul-Poel Yvonne H M, Smit Diederik L, de Ronde Willem
Department of Internal Medicine, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands.
Department of Internal Medicine, Elisabeth-TweeSteden Ziekenhuis, Tilburg, The Netherlands.
Eur J Case Rep Intern Med. 2021 Mar 4;8(3):002362. doi: 10.12890/2021_002362. eCollection 2021.
We describe a 29-year-old male bodybuilder with recurrent attacks of myalgia and muscle weakness associated with hypokalaemia and thyrotoxicosis due to abuse of liothyronine. The attacks quickly resolved after potassium supplementation and liothyronine cessation. We concluded that the patient had thyrotoxic hypokalaemic periodic paralysis (TPP). Although muscle weakness and hypokalaemia are prominent symptoms of TPP, underlying thyrotoxicosis may be overlooked. Up to 25% of androgen abusers also abuse thyroid hormone. Lack of recognition of thyroid hormone abuse as a cause of hypokalaemic periodic paralysis may result in unnecessary, potentially harmful medical investigations and improper treatment and advice.
In patients with bouts of muscle weakness and hypokalaemia, thyrotoxic hypokalaemic periodic paralysis should be suspected and thyroid function should be evaluated.In bodybuilders and strength athletes, undisclosed abuse of performance and image-enhancing drugs, including thyroid hormone, should be suspected.
我们描述了一名29岁的男性健美运动员，因滥用左甲状腺素，反复出现肌痛和肌肉无力发作，伴有低钾血症和甲状腺毒症。补充钾并停用左甲状腺素后，发作迅速缓解。我们得出结论，该患者患有甲状腺毒症性低钾性周期性麻痹（TPP）。尽管肌肉无力和低钾血症是TPP的突出症状，但潜在的甲状腺毒症可能被忽视。高达25%的雄激素滥用者也滥用甲状腺激素。未认识到甲状腺激素滥用是低钾性周期性麻痹的病因，可能导致不必要的、潜在有害的医学检查以及不恰当的治疗和建议。
对于出现肌肉无力和低钾血症发作的患者，应怀疑甲状腺毒症性低钾性周期性麻痹，并评估甲状腺功能。对于健美运动员和力量型运动员，应怀疑其未披露的滥用包括甲状腺激素在内的提高成绩和改善形象药物的情况。
