Szeto C C, Chow C C, Li K Y, Ko T C, Yeung V T, Cockram C S
Department of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong.
Br J Rheumatol. 1996 Mar;35(3):289-91. doi: 10.1093/rheumatology/35.3.289.
A 34-yr-old Chinese woman presented with hypokalaemic periodic paralysis. She had a goitre and was biochemically thyrotoxic. However, she also had urinary potassium loss with a metabolic acidosis and reduced ability to acidify her urine. The co-existence of distal renal tubular acidosis (RTA) was confirmed. There was no evidence of xerostomia or xerophthalmia, although anti-Ro antibody and rheumatoid factor were positive. Paralytic attacks did not recur after the thyrotoxicosis was controlled with radioactive iodine. Possible pathogenic mechanisms for the association of these disorders are discussed. Female patients presenting with thyrotoxic periodic paralysis (TPP) should be thoroughly investigated for possible additional precipitating factors in view of the strong male predominance of TPP, particularly when there are atypical metabolic features.
一名34岁的中国女性因低钾性周期性麻痹就诊。她有甲状腺肿大，生化检查显示甲状腺毒症。然而，她还存在尿钾丢失伴代谢性酸中毒以及尿液酸化能力下降。远端肾小管酸中毒（RTA）并存得到证实。尽管抗Ro抗体和类风湿因子呈阳性，但没有口干或眼干的证据。放射性碘控制甲状腺毒症后，麻痹发作未再复发。讨论了这些疾病关联的可能致病机制。鉴于甲状腺毒症性周期性麻痹（TPP）明显以男性为主，尤其是存在非典型代谢特征时，对于出现TPP的女性患者应全面检查是否存在其他可能的诱发因素。
