Paralysie périodique hypokaliémique thyrotoxique chez deux femmes noires africaines

Abstract

La paralysie périodique hypokaliémique thyrotoxique est une complication rare de l'hyperthyroïdie. Plus souvent rapportée chez les sujets asiatiques, elle est peu décrite dans la population noire. Son mécanisme peu élucidé, serait lié à une hyper activité de la pompe Na+/K+. Nous présentons deux cas de cette affection survenant chez des sujets noirs africains. La présentation clinique était identique chez les deux malades. Elle était faite d´une paralysie musculaire proximal des membres inférieurs. Cette paralysie était associée à une hypokaliémie sévère et survenait chez des patientes suivies pour maladie de Basedow sans autre pathologie associée. L´évolution a été rapidement favorable sous supplémentation potassique. Le traitement de l´hyperthyroïdie a permis d´éviter les récidives. Ces observations montrent l´importance d´évoquer le diagnostic de paralysie périodique hypokaliémique thyrotoxique malgré la rareté dans la population noire africaine.

A rare case of thyrotoxic periodic paralysis revealing Graves' disease in a young Malian

“…However, it is still not clear how these different potassium levels lead or are associated to the same symptoms. TPP is commonly reported in the Asian population, rare in Caucasians and exceptional in people with black ancestry 7,8 . Large cohort studies are lacking to explain these differences.…”

“…TPP is commonly reported in the Asian population, rare in Caucasians and exceptional in people with black ancestry. 7,8 Large cohort studies are lacking to explain these differences. While thyrotoxicosis is more frequent in women, the TPP are predominant in men, 1 which may suggest that the disease is not solely due to thyrotoxicosis but intercurrent factors may be involved.…”

“…TPP is a clinical entity that has common similar symptoms with the familial periodic paralysis (FPP) which is a dominant condition and is not linked to a hyperthyroidism. It is extremely rare in populations with black ancestry with only few cases reported in Africa and in Africans from the diaspora 4,7,8 . Here we report a case of a Malian adolescent who was admitted in the Department of Neurology of the Teaching Hospital of Point G for acute tetraparesis after effort.…”

“…It is extremely rare in populations with black ancestry with only few cases reported in Africa and in Africans from the diaspora. 4,7,8 Here we report a case of a Malian adolescent who was admitted in the Department of Neurology of the Teaching Hospital of Point G for acute tetraparesis after effort.…”

Paralisia Periódica Hipocalêmica Tireotóxica: Relato De Caso

“…Ao somar quadro clínico sugestivo com os baixos níveis de potássio, T3 e T4 séricos elevados e supressão do TSH, a hipótese de paralisia periódica hipocalêmica tireotóxica torna-se signi cativa. Aliado a isso, a remissão dos sintomas com a reposição de potássio e retorno do estado eutireoideo tornam a hipótese fortemente sugestiva (MESEEHA et al, 2017) Reconhecida a paralisia periódica hipocalêmica tireotóxica, prontamente o seu tratamento deve ser iniciado com a reposição de potássio e essa deve ser administrada lentamente para evitar arritmias ventriculares e paralisia dos músculos respiratórios (SOW et al, 2020). O cuidado de se administrar lentamente essa reposição deve-se ao risco de hipercalemia de rebote, que pode acontecer em cerca de 40% dos pacientes.…”