Thyrotoxic Periodic Paralysis Presenting as Polymorphic Ventricular Tachycardia Induced by Painless Thyroiditis

Lee, Jee In; Sohn, Tae Seo; Son, Hyun Shik; Oh, Su Jin; Kwon, Hyuk Sang; Chang, Suyon; Yun, Bong; Son, Ho Young; Lee, Kwang Woo

doi:10.1089/thy.2009.0253

Cited by 17 publications

(12 citation statements)

References 3 publications

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“…Only two patients with thyrotoxic periodic paralysis due to a painless thyroiditis have been reported (2,3). There are a few descriptions of fatal ventricular arrhythmias in patients with thyrotoxicosis due to Graves' disease, but only one case with painless thyroiditis has been published (2). We herein describe a rare and lifethreatening case of painless thyroiditis that was complicated by severe hypokalemia, thyrotoxic paralysis, polymorphic ventricular tachycardia (VT), and rhabdomyolysis-induced acute kidney injury that required dialysis.…”

Section: Introductionmentioning

confidence: 96%

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Severe Hypokalemia and Thyrotoxic Paralysis from Painless Thyroiditis Complicated by Life-threatening Polymorphic Ventricular Tachycardia and Rhabdomyolysis

et al. 2014

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A 61-year-old man presented with lower extremity paralysis and severe hypokalemia. His thyroid function test showed thyrotoxicosis. Despite attempts to correct his hypokalemia, he developed pulseless polymorphic ventricular tachycardia two hours later. He was successfully resuscitated after defibrillation. We performed continuous venovenous hemodiafiltration for 10 days due to acute kidney injury and rhabdomyolysis. We observed life-threatening polymorphic ventricular tachycardia requiring urgent defibrillation, as well as rhabdomyolysis requiring dialysis during the transient thyrotoxic phase of painless thyroiditis. Pay attention to the possibility of the development of life-threatening ventricular tachycardia associated with hypokalemia in the setting of thyroiditis and thyrotoxic paralysis.

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Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Severe Hypokalemia and Thyrotoxic Paralysis from Painless Thyroiditis Complicated by Life-threatening Polymorphic Ventricular Tachycardia and Rhabdomyolysis

et al. 2014

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“…It is extremely rare for thyrotoxic patients without underlying cardiac disease to have Vf. Vf attacks have been documented mainly in Asian males suffering from hypokalemic periodic paralysis associated with GD (5-7) and painless thyroiditis (8). In these patients, Vf was likely triggered as a result of a prolonged QT interval produced by their electrolyte disturbance (9).…”

Section: Introductionmentioning

confidence: 99%

Graves' Disease Complicated by Ventricular Fibrillation in Three Men Who Were Smokers

Ando

Henmi²,

Haruta³

et al. 2011

Thyroid

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Background: Thyrotoxicosis is known to be associated with sinus tachycardia and supraventricular tachyarrhythmias, but rarely with ventricular fibrillation (Vf), which has only occurred in some patients with hypokalemic periodic paralysis or ischemic heart disease. Patient Findings: We present three men who were transferred to our hospital with Graves' disease who developed idiopathic Vf. None of them had hypokalemic periodic paralysis or ischemic heart disease but all were smokers. None of other patients with thyrotoxicosis (587 females and 155 males) who were seen at our hospital, in the period during which the three men were seen, had idiopathic Vf. In our three men with thyrotoxicosis and idiopathic Vf, there was no identifiable underlying heart disease. One of the three patients died of hypoxic encephalopathy. The other two men did not have recurrent Vf after their thyroid function normalized. Summary: These cases and a review of similar cases in the literature imply that improving thyrotoxicosis seems to be effective for treating idiopathic Vf in some patients. Conclusions: Our findings suggest that thyroid hormone excess might play a direct role in the development of Vf in susceptible individuals. Our experience with these three patients suggests that smoking men with thyrotoxicosis likely have an increased risk for Vf, even if they do not have other predisposing factors.

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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%

“…The most common cause of TPP in thyrotoxicosis is Graves' disease, although TPP can occur with any form of thyrotoxicosis (1, 2). It is less commonly associated with thyroiditis (3, 4), toxic adenoma (5), T4 ingestion and iodine excess (6). However, very few cases such as this one have been reported as far as we know that thyrotoxic periodic paralysis associated with painless thyroiditis.…”

Section: Introductionmentioning

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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Thyrotoxic Periodic Paralysis Presenting as Polymorphic Ventricular Tachycardia Induced by Painless Thyroiditis

Abstract: FIG. 2. Tc-99m thyroid scan on admission (A) and followup after 3 months (B).

Cited by 17 publications

References 3 publications

Severe Hypokalemia and Thyrotoxic Paralysis from Painless Thyroiditis Complicated by Life-threatening Polymorphic Ventricular Tachycardia and Rhabdomyolysis

Severe Hypokalemia and Thyrotoxic Paralysis from Painless Thyroiditis Complicated by Life-threatening Polymorphic Ventricular Tachycardia and Rhabdomyolysis

Graves' Disease Complicated by Ventricular Fibrillation in Three Men Who Were Smokers

Thyrotoxic Periodic Paralysis Associated with Transient Thyrotoxicosis Due to Painless Thyroiditis

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