Tan Sarah Ying Tse, Xiong Jiaqing, Puar Troy H, Khoo Joan, Wong Andy Jun-Wei, Soh Shui Boon
Department of Endocrinology, Changi General Hospital, Singapore.
Case Rep Med. 2022 Apr 29;2022:5827664. doi: 10.1155/2022/5827664. eCollection 2022.
A previously well 32-year-old Chinese male presented with acute bilateral upper and lower limb paralysis upon waking, ten days after the onset of COVID-19 infection. Examination revealed areflexia over all four limbs, associated with reduced muscle strength, but no sensory or cranial nerve deficit. Initial concern was Guillain-Barre syndrome given the acute flaccid paralysis following COVID-19 infection. However, investigations revealed severe hypokalaemia (1.7 mmol/L) and primary hyperthyroidism. He was treated for thyrotoxic periodic paralysis (TPP) with -blockers, antithyroid medications, and intravenous potassium chloride (KCl). Despite frequent monitoring of potassium, rebound hyperkalaemia occurred with prompt resolution of paralysis.
一名32岁的中国男性，此前身体健康，在感染新冠病毒10天后醒来时出现急性双侧上下肢瘫痪。检查发现四肢腱反射消失，伴有肌力减弱，但无感觉或颅神经功能缺损。鉴于新冠病毒感染后出现急性弛缓性麻痹，最初怀疑是吉兰-巴雷综合征。然而，检查发现严重低钾血症（1.7 mmol/L）和原发性甲状腺功能亢进。他接受了β受体阻滞剂、抗甲状腺药物和静脉注射氯化钾（KCl）治疗甲状腺毒症性周期性麻痹（TPP）。尽管频繁监测血钾，但仍出现了反弹性高钾血症，同时瘫痪迅速缓解。
