Ho Ai Phi Thuy, Tjønnfjord Eirik Brekka, Moe Ragnar Bekkhus
Avdeling for hjertesykdommer, Sykehuset Østfold Kalnes.
Trombosepoliklinikken, Sykehuset Østfold Kalnes, Og, Oslo universitetssykehus, Rikshospitalet.
Tidsskr Nor Laegeforen. 2024 Apr 30;144(9). doi: 10.4045/tidsskr.23.0736. Print 2024 Aug 20.
Thyrotoxic periodic paralysis is a rare and serious complication of hyperthyroidism.
A man in his thirties of Asian descent, with non-compliant Graves' disease, presented with extremity paresis. Emergency blood tests revealed severe hypokalaemia, leading to a diagnosis of thyrotoxic periodic paralysis. The combination of uncontrolled hyperthyroidism, Asian ethnicity, paralysis, and severe hypokalaemia without other causes defined the diagnosis. Acute treatment involves non-selective beta-blockers, addressing hyperthyroidism, and potassium supplements.
Swift recognition of thyrotoxic periodic paralysis is crucial for timely and life-saving treatment. If triggered by hyperthyroidism, as in Graves' disease, surgery or radioiodine is strongly indicated for definitive treatment. It is noteworthy that euthyroid patients cannot develop thyrotoxic periodic paralysis.
甲状腺毒症性周期性瘫痪是甲状腺功能亢进症一种罕见且严重的并发症。
一名三十多岁的亚裔男性,患有未规范治疗的格雷夫斯病,出现肢体麻痹。急诊血液检查显示严重低钾血症,从而诊断为甲状腺毒症性周期性瘫痪。未控制的甲状腺功能亢进、亚裔种族、麻痹以及无其他病因的严重低钾血症共同确定了该诊断。急性治疗包括使用非选择性β受体阻滞剂、治疗甲状腺功能亢进以及补充钾。
迅速识别甲状腺毒症性周期性瘫痪对于及时进行挽救生命的治疗至关重要。如果像格雷夫斯病那样由甲状腺功能亢进引发,强烈建议进行手术或放射性碘治疗以进行确定性治疗。值得注意的是,甲状腺功能正常的患者不会发生甲状腺毒症性周期性瘫痪。