Periodic paralysis complicating thyrotoxicosis in Chinese.

McFadzean, A. J. S.; Yeung, Raymond W.

doi:10.1136/bmj.1.5538.451

Cited by 276 publications

(264 citation statements)

References 11 publications

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“…This is in keeping with the observations of Macfadean et al in Hong Kong who reported a male preponderance amongst their patients and a peak age of occurrence in the 4 th decade of life 4 . Like the patients in the Hong Kong study, this man had premonitory muscle aches, but unlike them, his paralytic episodes happened while he was walking which differed from the findings in the Hong Kong study.…”

Section: Discussionsupporting

confidence: 92%

“…The onset of premonitory muscle aches became warning signs for some of them to get active and work "work off" an impending attack. Trans and Reeves in Australia reported a case of similar paralysis in a gender assigned man, who was on maintenance testosterone and was also receiving interferon alpha for HCV infection 23 while Tigas et al working in Greece observed this disorder in a patient following intravenous administration of methyl prednisolone 24 which are unlike the situation in this patient who was not on any medication prior to the onset of the paralyses but has Graves disease which has been variously reported to be the commonest cause 2,3,4 . The hallmark of Thyrotoxic periodic paralysis is hypokalaemia 25,26 but occasionally if the patient is at the recovery phase of the paralysis, the serum potassium can be normal 26.…”

Section: Discussionmentioning

confidence: 98%

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Thyrotoxic Periodic Paralysis In A Nigerian: A Case Report

Ajayi¹

2012

IOSR-JDMS

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Abstarct :Thyrotoxic periodic paralysis is a disorder in which there are episodes of muscle weakness in people with high levels of thyroid hormones. It is a channelopathy characterized by an abnormality in the Na + /K+ ATPase pump due to the effect of excess thyroid hormones which cause an intracellular shift of potassium leading to hypokalaemia in the presence of normal total body potassium 1 . The commonest cause of hyperthyroidism in these patients is Grave's disease 2,3,4 but other causes have also been described 5,6. It is commoner in males than females unlike in other thyroid disorders 7,8,9. The modes of presentation include limb paralysis, dyspnoea, dysphagia, ophthalmoplegia, and cardiac rhythm disturbances. The attacks are potentially life threatening 10,11,12 but patients are normal between attacks. The condition is rare and is seen most commonly in Asian 13,14,15 and Latin American men 16

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Thyrotoxic Periodic Paralysis In A Nigerian: A Case Report

Ajayi¹

2012

IOSR-JDMS

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“…e paralysis can last 3 to 96 hours, and it resolves in the reverse order from which it occurred. Deep tendon reflexes are decreased or absent (1,(3)(4)(5). Rarely does the paralysis affect ocular, bulbar, or respiratory muscles, but ventilatory impairment has been reported (13).…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…It has been recognized in ais, Filipinos, Vietnamese, Koreans, Malaysians, Hispanics, African Americans, and Caucasians (1)(2)(3)(4)(5). TPP is characterized by acute onset of severe hypokalemia and profound proximal muscle weakness in patients with thyrotoxicosis (1).…”

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confidence: 99%

Thyrotoxic Periodic Paralysis

Re¹,

S²,

Walker³

2009

Encyclopedia of Neuroscience

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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. It has been increasingly reported in the USA due to the rise in the immigrant population. Hypokalemia in TPP results from an intracellular shift of potassium induced by the thyroid hormone sensitization of Na + /K + -ATPase rather than depletion of total body potassium. Treatment of TPP includes prevention of this shift of potassium by using nonselective beta-blockade, correcting the underlying hyperthyroid state, and replacing potassium. TPP is curable once a euthyroid state is achieved. It is important for physicians to distinguish TPP from familial hypokalemic periodic paralysis, a more common cause of periodic paralysis in Caucasians. The absence of a family history of paralysis, male sex, presentation in the second to fourth decades of life, and signs of thyrotoxicosis like sinus tachycardia help in the diagnosis of this disorder. Early recognition of TPP is vital to initiating appropriate treatment and to avoiding the risk of rebound hyperkalemia that may occur if high-dose potassium replacement is given.T hyrotoxic periodic paralysis (TPP) is most common in Asian populations, with an incidence of approximately 2% in patients with thyrotoxicosis of any cause. It has been recognized in ais, Filipinos, Vietnamese, Koreans, Malaysians, Hispanics, African Americans, and Caucasians (1-5). TPP is characterized by acute onset of severe hypokalemia and profound proximal muscle weakness in patients with thyrotoxicosis (1).TPP is commonly misdiagnosed in western countries because of its similarities to familial periodic paralysis. Familial periodic paralysis is an autosomal dominant disorder caused by a defect in the gene coding for L-type calcium channel 1-subunit (CACNA1S) on chromosome 1q31-32 (2). e neuromuscular presentations of both are identical, and to enhance diagnosis of TPP, physicians need to look for subtle features of hyperthyroidism in the presence of hypokalemic periodic paralysis. Early diagnosis not only aids in definitive management with nonselective beta-blockers and correction of hyperthyroidism, but also prevents the risk of rebound hyperkalemia due to excessive potassium replacement. CASE REPORTA 33-year-old Hispanic man with a history of recurrent hypokalemia and muscle weakness presented to our emergency department with generalized muscle weakness more pronounced in his lower extremity. e patient's symptoms started in the early morning, and he was unable to walk to the bathroom. He had had similar episodes before and took potassium supplements sporadically. His initial episode of hypokalemia and paralysis had occurred 2 years earlier. He denied use of diuretics, laxatives, alcohol, or recreational drugs. He reported intermittent palpitations and diarrhea and had no family history of periodic paralysis.On physical examination, he had a mildly enlarged thyroid ...

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“…This condition mainly affects male patients of Asian descent, particularly Chinese and Japanese [2][3][4]. While the pathogenesis of TPP remains unclear, its clinical features are similar to those of an autosomal dominantly inherited syndrome, familial hypokalemic periodic paralysis (FHPP).…”

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Autonomously Functioning Thyroid Nodule Associated with Thyrotoxic Periodic Paralysis

et al. 2008

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Abstract. Thyrotoxic periodic paralysis (TPP) is mainly associated with Graves' disease but rarely with autonomously functioning thyroid nodule (AFTN). We herein report a case of AFTN associated with TPP in which the latter resolved after 131 I therapy for the former. We analyzed the genes encoding thyrotropin receptor (TSHR), the α-subunit of the stimulatory G protein (Gsα), calcium channel CACNA1S and potassium channel KCNE3, and found that the patient does not carry the known mutations in these genes. Whereas the pathogenesis of TPP and AFTN remains to be understood, the present case suggests that ion channel defects responsible for familial hypokalemic periodic paralysis may not be associated with TPP, and that mutations in TSHR and Gsα genes may be less frequent in AFTN patients in the Japanese population.

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Periodic paralysis complicating thyrotoxicosis in Chinese.

Cited by 276 publications

References 11 publications

Thyrotoxic Periodic Paralysis In A Nigerian: A Case Report

Thyrotoxic Periodic Paralysis In A Nigerian: A Case Report

Thyrotoxic Periodic Paralysis

Autonomously Functioning Thyroid Nodule Associated with Thyrotoxic Periodic Paralysis

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