Autonomously Functioning Thyroid Nodule Associated with Thyrotoxic Periodic Paralysis

Ozaki, Hiroshi; Mori, Keiichiro; Nakagawa, Yasuaki; Hoshikawa, Saeko; Ito, Sadayoshi; Yoshida, Katsumi

doi:10.1507/endocrj.k07e-017

Cited by 10 publications

(7 citation statements)

References 35 publications

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“…Patients with TPP have been reported with thyroiditis [26, 27], toxic adenoma [28], toxic nodular goiter [29], TSH-secreting pituitary adenoma [30, 31], ingestion of T4 or T3 [32, 33], inadvertent iodine excess [34], subacute thyroiditis of de Quervain [35], amiodarone therapy [36], radiation thyroiditis with Graves' disease [37], and nutraceuticals containing tiratricol [38]. …”

Section: Clinical Featuresmentioning

confidence: 99%

Thyrotoxic Periodic Paralysis: Clinical Challenges

Vijayakumar

Ashwath

Thimmappa

2014

Journal of Thyroid Research

156

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Thyrotoxic periodic paralysis (TPP), a disorder most commonly seen in Asian men, is characterized by abrupt onset of hypokalemia and paralysis. The condition primarily affects the lower extremities and is secondary to thyrotoxicosis. The underlying hyperthyroidism is often subtle causing difficulty in early diagnosis. Factors like high-carbohydrate meal exercise, steroid, and stress can precipitate an attack of TPP. Evidence is building up showing role of genetic mutations in Kir2.6 channel in the pathogenesis of TPP. Loss of function of Kir2.6 together with increased activity of Na+/K+ ATPase may trigger a positive feed-forward cycle of hypokalemia. Biochemical hyperthyroidism with normal urinary potassium excretion and ECG changes are characteristic of TPP. Treatment with low-dose potassium supplements and nonselective beta-blockers should be initiated upon diagnosis, and the serum potassium level should be frequently monitored to prevent rebound hyperkalemia.

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Section: Clinical Featuresmentioning

confidence: 99%

Thyrotoxic Periodic Paralysis: Clinical Challenges

Vijayakumar

Ashwath

Thimmappa

2014

Journal of Thyroid Research

156

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“…Patients with TPP have been reported with thyroiditis (3, 4), toxic adenoma (5), toxic nodular goiter (9), TSH-secreting pituitary adenoma (10, 11), ingestion of T4 or T3 (6, 12, 13), inadvertent iodine excess (14), subacute thyroiditis of de Quervain (15), amiodarone therapy (16), radiation thyroiditis with Graves' disease (17) and nutraceuticals containing triatricol (18). …”

Section: Discussionmentioning

confidence: 99%

Thyrotoxic Periodic Paralysis Associated with Transient Thyrotoxicosis Due to Painless Thyroiditis

Ahn

et al. 2012

J Korean Med Sci

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Thyrotoxic periodic paralysis (TPP) is a rare manifestation of hyperthyroidism characterized by muscle weakness and hypokalemia. All ethnicities can be affected, but TPP typically presents in men of Asian descent. The most common cause of TPP in thyrotoxicosis is Graves' disease. However, TPP can occur with any form of thyrotoxicosis. Up to our knowledge, very few cases ever reported the relationship between TPP and painless thyroiditis. We herein report a 25-yr-old Korean man who suffered from flaccid paralysis of the lower extremities and numbness of hands. The patient was subsequently diagnosed as having TPP associated with transient thyrotoxicosis due to painless thyroiditis. The paralytic attack did not recur after improving the thyroid function. Therefore, it is necessary that early diagnosis of TPP due to transient thyrotoxicosis is made to administer definite treatment and prevent recurrent paralysis.

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“…Sıklıkla Graves hastalığı ile ilişkilidir (4,10). Fakat Jod-Basedow fenomeni, tiroiditler, tiroid hormon kullanımı, soliter toksik tiroid nodülü, TSH salgılayan hipofizer adenom, radyoaktif iyot tedavisi ve Amiodaron ilişkili tirotoksikozda da tanımlanmıştır (11)(12)(13)(14)(15)(16). Olgumuz Graves hastalığı tanısıyla 1 yıl kadar antitiroid ilaç kullanmıştı ve Graves hastalığının nüksü esnasında Hipokalemik Periyodik Paraliz tanısı aldı.…”

Section: Discussionunclassified

Thyrotoxic Hypokalemic Periodic Paralysis: A Case Report

...

2012

Tjem

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ÖzetTirotoksik hipokalemik periyodik paraliz, tirotoksikozun nadir görülen bir komplikasyonudur. Tirotoksikoz, kadınlarda daha sık görülür buna karşın tirotoksikozda ortaya çıkabilen bu tablo özellikle Asya populasyonunda ve erkek cinsiyette sıktır. Etiyolojisi tam olarak bilinmeyen bu hastalıkta, potasyumun hücre içine kaçışı sorumlu mekanizma olarak belirtilmektedir. Suçlanan presipite edici faktörler; tiroid hormonları, karbonhidrattan zengin diyet, alkol kullanımı ve aşırı egzersizdir. Bu klinik tablo ilk atakta genelde zor tanınır. Burada 42 yaşında, ilk paralitik atağında tirotoksik hipokalemik periyodik paraliz tanısı konulan Basedow Graves hastası, bir erkek olgu sunuldu. Potasyum replasmanı, beta bloker ve antitiroid ilaç tedavisi sonrası paralizisi düzelen hastaya kalıcı tedavisi için radyoaktif iyot ablasyonu yapıldı. Türk Jem 2012; 16: 69-71 Anah tar ke li me ler: Tirotoksikoz, hipokalemi, paraliz Abs tractThyrotoxic hypokalemic periodic paralysis is a rare complication of thyrotoxicosis. This clinic condition is often encountered in Asian populations and male gender while thyrotoxicosis is frequently seen in women. The escape of potassium into cell is the mechanism responsible for this disease and its etiology is not completely known. Thyroid hormones, carbohydrate rich diet, alcohol consumption and excessive exercise are regarded as the precipitating factors. This clinical picture is generally difficult to define at first attack. Here, we report a forty-two-year-old male patient with Basedow-Graves disease who was diagnosed as having thyrotoxic hypokalemic periodic paralysis during the first paralytic attack. His symptoms improved after potassium replacement and treatment with beta-blocker and antithyroid drugs. The permanent cure was achieved with radioactive iodine ablation therapy. Turk Jem 2012; 16: 69-71

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Autonomously Functioning Thyroid Nodule Associated with Thyrotoxic Periodic Paralysis

Cited by 10 publications

References 35 publications

Thyrotoxic Periodic Paralysis: Clinical Challenges

Thyrotoxic Periodic Paralysis: Clinical Challenges

Thyrotoxic Periodic Paralysis Associated with Transient Thyrotoxicosis Due to Painless Thyroiditis

Thyrotoxic Hypokalemic Periodic Paralysis: A Case Report

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