J Korean Acad Rehabil Med.  2004 Aug;28(4):392-395.

Induced Life-Threatening Electrolyte Imbalance in Sub-clinical Hyperthyroidism -A case report-

• Kim JM
• Lee JM
• Kim SJ
• Kho SE
• Chung JS
• Bang HJ

Abstract

Thyrotoxic periodic paralysis (TPP) is rare in white Caucasian but a few in Asian. A 36-year-old man presented with suddenly developed paraparesis was brought by ambulance. He got some medications and injection for the upper respiratory infection in the morning of admission day. On admission he revealed bilateral proximal muscle weakness without pain. He didn't have any specific medical history of himself and his family. The laboratory results on admission revealed severe hypokalemia (2.1 mM/l). Potassium replacement was immediately started and his symptom was gone. We found TSH was extremely decreased (<0.005 microIU/ml) but T3 and T4 were within normal level. We guess TPP was induced by some drugs to the patient with sub-clinical hyperthyroidism. Hyperthyroidism is not always clinically apparent and then may be easily missed. However just a single medication or injection that is usually prescribed can induce critical progressive hypokalemia.

Keyword

Thyrotoxic periodic paralysis; Subclinical hyperthyroidism; Hypokalemia

MeSH Terms

Adult
Ambulances
Asian Continental Ancestry Group
Humans
Hyperthyroidism*
Hypokalemia
Muscle Weakness
Paralysis
Paraparesis
Potassium
Potassium