Hypokalaemic periodic paralysis in rural northern India – most have secondary causes

Kumar, Vinod; Armstrong, Lois; Seshadri,; Finny, Philip

doi:10.1177/0049475513512643

Cited by 11 publications

(9 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Table 4 compares this study with the available literature worldwide. [ 9 10 11 12 ] dRTA as a cause of hypokalemic paralysis in our study is similar to various published Indian studies (40%–69%). [ 14 ] dRTA accounts for 93% and pRTA was seen in 7%.…”

Section: Discussionsupporting

confidence: 91%

Spectrum of hypokalemic paralysis from a tertiary care center in India

et al. 2018

View full text Add to dashboard Cite

Hypokalemic paralysis is an important and reversible cause of acute flaccid paralysis. The treating physician faces unique diagnostic and therapeutic challenges. We did a prospective study and included all patients with acute flaccid weakness and documented serum potassium of <3.5 mEq/L during the period between January 2009 and August 2015. We studied the incidence, etiology, clinical profile, and acid–base disturbances in patients presenting with hypokalemic paralysis and analyzed the significance of periodic and non-periodic forms of hypokalemic paralysis on patient's outcome. Two hundred and six patients were studied with a mean follow-up of 3.6 ± 1.2 years. Mean age was 37.61 ± 2.2 years (range 18–50 years). Males were predominant (M:F ratio 2.1:1). The nonperiodic form of hypokalemic paralysis was the most common (61%). Eighty-one (39%) patients had metabolic acidosis, 78 (38%) had normal acid–base status, and 47 (23%) patients had metabolic alkalosis. The most common secondary cause was distal renal tubular acidosis (RTA) (n = 75, 36%), followed by Gitelman syndrome (n = 39, 18%), thyrotoxic paralysis (n = 8, 4%), hyperaldosteronism (n = 7, 3%), and proximal RTA (n = 6, 4%). Patients with non-periodic paralysis had more urinary loss (40.1 vs. 12.2 mmol, P = 0.04), more requirement of potassium replacement (120 vs. 48 mmol, P = 0.05), and longer recovery time of weakness (48.1 vs. 16.5 h, P = 0.05) than patients with periodic paralysis. Non-periodic form of hypokalemic paralysis was the most common variant in our study. Patients with periodic paralysis had significant incidence of rebound hyperkalemia.

show abstract

Section: Discussionsupporting

confidence: 91%

Spectrum of hypokalemic paralysis from a tertiary care center in India

et al. 2018

View full text Add to dashboard Cite

show abstract

“…these findings had corroborated our findings of atypical manifestations. Whereas the study done by Kumar et al 12 had shown a tendency of hot climate as a trigger, we had found the same in only three cases. We had found hard work or heavy physical labor to be the commonest precipitating factor (Figure 3).…”

Section: Discussioncontrasting

confidence: 77%

“…Thyrotoxic hypokalemic paralysis is common in the Asian population whereas familial periodic paralysis is common in Caucasians. [5][6][7] In India, until recently and excepting few, [8][9][10][11][12][13] no large case series have been reported.…”

Section: Introductionmentioning

confidence: 99%

Idiopathic hypokalemic periodic paralysis: A series of cases clustered in a part of Eastern India

et al. 2015

View full text Add to dashboard Cite

Background:Most of the studies on hypokalemic periodic paralysis (HOPP) in India and abroad had described secondary causes as the origin of the disease. We had observed a series of HOPP cases clustered within 40 kilometers around Bankura, a district town of West Bengal, Eastern India. The aim of our study was to probe into the clinical, biochemical and electrophysiological details of the cases, which were found to be idiopathic. Material and Methods: 32 idiopathic HOPP cases, attending the neurology OPD or admitted in Bankura Sammilani Medical College & Hospital (BSMCH), were selected from October 2006 to May 2008. All the secondary causes of HOPP were excluded. The patients were evaluated and the data was analyzed. Results: Cases were clustered within a 40-kilometer radius from Bankura town, location of BSMCH. Male: female = 4.3:1. Median age of onset was 23.5 years (4-50 years). Median number of attacks was 2.5, (1 to 70); duration 3 hours -6 days, median 3 days. Strenous physical activity was most common precipitating factor. 25% had bulbar symptoms, 9.4% had bladder dysfunction and 46.9% had diminished to absent deep tendon reflexes. Mean serum potassium = 2.45 mEq/L (1.4 -3.1 mEq/L). Conclusion: We had observed a group of idiopathic HOPP cases within a relatively small area in a short span of time in contrast to most other Indian studies, where the share of idiopathic aetiology is comparatively smaller. This underscores the importance of a larger study with genetic analysis on the aetiology of the idiopathic HOPP in this area.

show abstract

“…In one series, renal tubular acidosis was the most frequent cause of hypokalemia with paralysis. 30,31 This is particularly the case if there is substantial potassium depletion or if provoked by high-carbohydrate caloric sources. 32 Autoimmune disorders such as Sjögren's syndrome and pernicious anemia should also alert the clinician to the possibility of renal tubular acidosis and potassium depletion as potential causes of hypokalemic paralysis.…”

Section: Figurementioning

confidence: 99%