Pisano Thomas J, Merical Brandon, Wang Zehui, Levine Joshua M
Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
Neurohospitalist. 2025 Jun 2:19418744251347781. doi: 10.1177/19418744251347781.
Thyrotoxic periodic paralysis (TPP) is a rare, life-threatening, reversible condition, in which episodic muscle weakness occurs due to low serum potassium in the setting of thyrotoxicosis. In addition to treating thyrotoxicosis, prompt restoration of potassium levels is essential while monitoring for rebound hyperkalemia. To emphasize the importance of recognizing and appropriately managing TPP, with a focus on the potential dangers of potassium overcorrection. We present a patient with TPP whose potassium replacement therapy caused dangerous hyperkalemia, requiring aggressive potassium shifting and wasting therapies and vasopressor support. This case report highlights the importance of prompt recognition and treatment of TPP as well as the need for careful management of potassium levels to prevent respiratory failure and cardiac arrhythmias. We discuss the challenges associated with potassium repletion in thyrotoxicosis including the importance of careful monitoring and titration of potassium replacement therapy to avoid overcorrection and hyperkalemia.
甲状腺毒症性周期性瘫痪（TPP）是一种罕见的、危及生命的、可逆转的病症，在甲状腺毒症的情况下，由于血清钾水平降低而出现发作性肌无力。除了治疗甲状腺毒症外，在监测是否发生反弹性高钾血症的同时，迅速恢复血钾水平至关重要。为强调认识和妥善管理TPP的重要性，重点关注钾过度纠正的潜在危险。我们报告一例TPP患者，其补钾治疗导致危险的高钾血症，需要积极的钾转移和消耗疗法以及血管升压药支持。本病例报告强调了及时识别和治疗TPP的重要性，以及谨慎管理血钾水平以预防呼吸衰竭和心律失常的必要性。我们讨论了甲状腺毒症补钾相关的挑战，包括仔细监测和滴定补钾治疗以避免过度纠正和高钾血症的重要性。
