Hypokalemic Periodic Paralysis as the First Sign of Thyrotoxicosis- A Rare Case Report from Somalia

Abstract

Background: Thyrotoxic hypokalemic periodic paralysis (THPP) is a rare complication of hyperthyroidism and is marked by thyrotoxicosis, hypokalemia, and paralysis. It is the most commonly acquired form of periodic paralysis. It has been most commonly reported in Asian subjects, with limited information on the black population. This is precipitated by strenuous exercise, high carbohydrates, stress, infection, alcohol, albuterol, and corticosteroid therapy. Case Presentation: We present a 29-year-old male patient admitted from the emergency department with a complaint of sudden onset of paralysis after a high carbohydrate meal. Laboratory investigations showed low potassium chloride 1.8 mEq/l, TSH 0.006 miu/l, T3 3.2 ng/ml. T4 13.5 ng/ml. Potassium chloride infusion and antithyroid drugs were given. Conclusion: To prevent deadly consequences (cardiac and respiratory), it is critical to diagnose THPP early and treat the electrolyte imbalance that is precipitated by strenuous exercise and high carbohydrate meals.