Korean J Med.  2005 Jun;68(6):692-696.

A case of hypokalemic perodic paralysis induced by hyperinsulinemia

• Chang JH
• Kim CS
• Park JK
• Park J
• Cho MH
• Ahn CW
• Kim KR

Abstract

Hypokalemia periodic paralysis, a clinical syndrome characterised by systemic weakness and low serum potassium, is a rare but treatable cause of acute weakness. Attacks of flaccid paralysis can be associated with hypokalemia triggered by insulin. Insulin reduce the conductance of the inward rectifier K+ channel for outward-flowing currents. Therefore, insulin potentiates depolarization of hypokalmeic periodic paralysis. We have experienced a case of hypokalemic periodic paralysis induced by hyperinsulinemia in 38-year old man, with complaint of intermittent paralysis of extremities. On admission, serum K+ was 2.1 mEq/L. He was no family history of muscle weakness. Thyroid function was normal. Serum levels of aldosterone, renin and cortisol were normal. Random plasma glucose level was 129 mg/dL and serum insulin was 131 uIU/mL. Shortly after intravenous supplementation of potassium, muscle weakness was improved. Oral glucose tolerance test revealed impaired glucose tolerance and hyperresponse of insulin and phosphate.

Keyword

Paralysis; Hypokalemic Periodic; Hyperinsulinemia

MeSH Terms

Adult
Aldosterone
Blood Glucose
Extremities
Glucose
Glucose Tolerance Test
Humans
Hydrocortisone
Hyperinsulinism*
Hypokalemia
Hypokalemic Periodic Paralysis
Insulin
Muscle Weakness
Paralysis*
Potassium
Potassium Channels, Inwardly Rectifying
Renin
Thyroid Gland
Aldosterone
Glucose
Hydrocortisone
Insulin
Potassium
Potassium Channels, Inwardly Rectifying
Renin