The pitfalls of potassium replacement in thyrotoxic periodic paralysis: a case report and review of the literature

J Emerg Med. 2004 Feb;26(2):157-61. doi: 10.1016/j.jemermed.2003.05.004.

Abstract

Thyrotoxic Periodic Paralysis is an uncommon disorder seen primarily in Asian males and caused by excessive thyroid hormones. This is an endocrine emergency that can lead to respiratory failure, dysrhythmia, and death. The mainstay of therapy has been potassium replacement, however, recent evidence suggests propranolol is a more effective therapy. We present a severe case of TPP in a 22-year-old Latino male with rapidly progressive ascending paralysis and hypokalemia severe enough to lead to cardiac arrest.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anti-Arrhythmia Agents / administration & dosage
  • Emergency Medical Services / methods*
  • Humans
  • Hyperkalemia / chemically induced*
  • Hyperthyroidism / complications
  • Hyperthyroidism / diagnosis
  • Hyperthyroidism / therapy
  • Hypokalemic Periodic Paralysis / complications
  • Hypokalemic Periodic Paralysis / drug therapy*
  • Infusions, Intravenous
  • Male
  • Potassium / administration & dosage
  • Potassium / adverse effects*
  • Propranolol / administration & dosage
  • Tachycardia, Ventricular / diagnosis
  • Tachycardia, Ventricular / drug therapy
  • Tachycardia, Ventricular / etiology
  • Thyrotoxicosis / complications
  • Treatment Outcome

Substances

  • Anti-Arrhythmia Agents
  • Propranolol
  • Potassium