J Korean Soc Pediatr Endocrinol.  2011 Dec;16(3):196-200. 10.6065/jkspe.2011.16.3.196.

A Case of Thyrotoxic Periodic Paralysis in Adolescent with Graves' Disease

• Oh KW
• Jeong JY
• Kim JS

• KMID: 2001502
• DOI: http://doi.org/10.6065/jkspe.2011.16.3.196

Abstract

Thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism characterized by recurrent paralysis of skeletal muscle and hypokalemia caused by a massive intracellular shift of potassium. TPP mainly affects young male patients of Asian descent. We describe a case of TPP in a 14-year-old girl who presented with palpitation and intermittent weakness of the lower extremities especially after physical exercises. The patient showed sinus tachycardia, proximal weakness of both legs and a severe hypokalemia. Thyroid function tests showed hyperthyroidism, and thyroid scan revealed diffusely enlarged goiter consistent with Graves' disease. After the management with antithyroid drug, beta-adrenergic blocker and potassium supplementation for TPP, she has remained euthyroid state and symptom free on the follow-up. TPP should be considered in children with acute paralysis of skeletal muscle and hypokalemia, also thyroid function should be evaluated.

Keyword

Hyperthyroidism; Hypokalemic periodic paralysis; Adolescent

MeSH Terms

Adolescent
Asian Continental Ancestry Group
Child
Exercise
Follow-Up Studies
Goiter
Graves Disease
Humans
Hyperthyroidism
Hypokalemia
Hypokalemic Periodic Paralysis
Leg
Lower Extremity
Male
Muscle, Skeletal
Paralysis
Potassium
Tachycardia, Sinus
Thyroid Function Tests
Thyroid Gland
Potassium