Gamper G, Stulnig T, Weissel M
Klinischen Abteilung für Notfallmedizin, Ludwig-Boltzmann-Institut für Nuklearmedizin, Wien.
Acta Med Austriaca. 1998;25(3):106-8.
Thyrotoxic hypokalemic periodic paralysis has been described to occur quite frequently in male Asiatic patients. The syndrome is, however, very rare in patients of Caucasian origin. To our knowledge it has never been described in Austria so far. This is the reason why we present the following case: A 22-year old male patient of Kurdish origin suffered from two periods of typical flaccid paralysis of the extremities after strenuous physical exertion, that were 4 months apart. The periods of paralysis were quickly reversed by substitution with potassium. Graves' disease was retrospectively diagnosed to have existed already during the first period. The patient was treated with an ablative dose of 131-I (25 mCi) and can perform strenuous exercise without symptoms since. This case and the review of the literature clearly illustrates the advantage of screening for thyroid dysfunction in patients with flaccid paralysis: unnecessary further periods of paralysis can be avoided by the correct treatment of thyrotoxicosis in such patients.
甲状腺毒症性低钾性周期性麻痹在亚洲男性患者中较为常见。然而,该综合征在白种人患者中非常罕见。据我们所知,奥地利至今尚未有相关报道。因此,我们在此呈现以下病例:一名22岁的库尔德裔男性患者,在剧烈运动后出现了两期典型的肢体弛缓性麻痹,两期相隔4个月。通过补钾,麻痹期迅速得到缓解。回顾性诊断发现,第一期时患者就已患有格雷夫斯病。患者接受了131碘(25毫居里)的消融剂量治疗,此后能够进行剧烈运动且无任何症状。该病例及文献回顾清楚地表明,对弛缓性麻痹患者进行甲状腺功能障碍筛查具有重要意义:通过正确治疗此类患者的甲状腺毒症,可避免不必要的后续麻痹发作。