Hypokalaemia

Thyrotoxic Periodic Paralysis: A Case Report with Patient Perspective

Case Reports, Volume 23, Issue 2, Pages 53 – 96 (2024)

We present a case report on a spot diagnosis of Thyrotoxic Periodic Paralysis (TPP) with a unique first-person account of events from the patient. It illustrates the importance of pattern recognition and exemplifies how timely treatment enables quick resolution of a life-threatening medical emergency. Patient X’s account affirms the condition’s insidious onset and rapid deterioration. This case highlights the need for raising awareness of diseases that are more prevalent in specific ethnic groups and is particularly crucial for work in culturally diverse environments. We hope by sharing our experience, readers will be prompted to consider TPP as a differential diagnosis for acute limb weakness in an acute setting; with prompt testing of thyroid function and initiation of the appropriate treatments.

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An Unusual Case of Acute Muscle Weakness

Case Reports, Volume 15, Issue 4, Pages 165 – 220 (2016)

A previously healthy 35-year old man presented to hospital with acute leg weakness following an alcohol binge. On assessment, tachycardia, urinary retention and bilateral upper and lower limb proximal weakness with preserved peripheral power were noted. Biochemistry revealed marked hypokalaemia, which responded to intravenous replacement, and biochemical thyrotoxicosis, leading to the diagnosis of Thyrotoxic Periodic Paralysis (TPP). Anti-thyroid therapy and beta-blockers were commenced and his neurological symptomatology resolved as he became progressively euthyroid. TPP is a rare acquired subtype of hypokalaemic periodic paralysis, typically causing proximal muscle weakness associated with thyrotoxicosis. It is most common in young Asian males. Acute treatment requires cautious oral potassium supplementation, beta-blockade, and anti-thyroid therapy. TPP is prevented by maintaining euthyroidism; otherwise recurrence is likely.

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Periodic Paralysis: An Unusual Presentation of Thyrotoxicosis

Case Reports, Volume 10, Issue 4, Pages 173 - 232 (2011)

Abstract

Thyrotoxic Periodic Paralysis (TPP) is a rare complication of thyrotoxicosis and is up to 20 times more common in males. Cases usually present with painless muscle weakness precipitated by heavy exercise, fasting, an alcohol binge or large carbohydrate meal. Serum potassium is low in the majority, but normokalaemic (or even hyperkalaemic) TPP is recognised. Acute treatment of any electrolyte disorder, administration of a beta-blocker and treatment of the thyrotoxicosis leads to complete resolution. This rare diagnosis should be considered by the Acute Physician when confronted with any case of muscle weakness.

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Caffeine Overdose with Rhabdomyolysis and Hypokalaemia

Case Reports, Volume 6, Issue 2, Pages 49 - 92 (2007)

Abstract

Caffeine, a normal content of various beverages and over the counter medications, taken in higher doses can cause serious toxicity. Complications like rhabdomyolysis and acute renal failure, which are life threatening, are reversible if diagnosed early and treated appropriately. Caffeine toxicity can also cause serious hypokalaemia, which needs prompt correction. Here we present a patient with caffeine toxicity complicated by rhabdomyolysis and acute renal failure who made a complete recovery.

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