Abstract
Background
Patients presenting to the emergency department with paralysis can have a wide differential
diagnosis. Thyrotoxic periodic paralysis (TPP) is a rare disorder causing transient
flaccid paralysis in the setting of thyrotoxicosis and hypokalemia. It has been reported
in Asian male populations predominantly, and the diagnosis is rarely considered in
non-Asian populations. Recent research has identified cases in patients with diverse
ethnic backgrounds, although epidemiologic data from the United States are very limited.
Objective
Our aim was to report our experience with TPP at a tertiary care center in the United
States.
Methods
A retrospective chart review was conducted between January 2006 and February 2022
to identify cases of TPP and determine their demographic and clinical characteristics.
Prevalence of TPP was estimated using the institutional hyperthyroidism registry.
Results
Thirty-three patients with TPP were identified. All of the patients were male; median
age was 28 years, and 85% were Hispanic. All patients had hypokalemia at presentation
and 23% had rebound hyperkalemia after treatment. Prevalence of TPP in our population
of patients with hyperthyroidism was approximately 0.5%.
Conclusions
Young Hispanic men presenting with paralysis should be evaluated for TPP, as the prevalence
in this population may be higher than estimated previously. Management of TPP involves
treatment of underlying hyperthyroidism and cautious potassium repletion, with an
initial dose of no more than 60 mEq/L of potassium chloride to avoid rebound hyperkalemia.
Keywords
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Article info
Publication history
Published online: October 28, 2022
Accepted:
October 21,
2022
Received in revised form:
September 13,
2022
Received:
July 15,
2022
Identification
Copyright
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