CASE REPORTS   

Panminerva Medica 2000 December;42(4):293-4

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Thyrotoxic periodic paralysis in a Caucasian man in treatment for Graves’ disease

Didonna D., D’Alessandro G., De Michele A., Conte M., Storelli A., Totaro M., Altomare E.

From the Department of Internal Medicine Faculty of Medicine, University of Foggia, Foggia, Italy

Thyrotoxic peri­odic par­al­ysis (TPP) is the ­main sec­on­dary ­form of hypo­ka­lemic peri­odic par­al­ysis and is ­mostly asso­ciated ­with Graves’ dis­ease. Initially diag­nosed in Asian coun­tries, TPP has ­been spo­rad­i­cally ­reported in dif­ferent pop­u­la­tions of the Western World. Increased Na+/K+-ATPase ­activity ­seems to be respon­sible for the ­marked hypo­ka­lemia ­observed ­during the tran­sient par­al­ysis ­attacks. We ­report on a 35-­year-old Italian man ­without his­tory of hypo­ka­lemic peri­odic par­al­ysis and hyper­thyr­oi­dism, in treat­ment for Graves’ dis­ease, who suf­fered epi­sodes of ­flaccid par­al­ysis ­even ­with ­normal thy­roid hor­mone ­levels. An ­insulin-glu­cose prov­o­ca­tion ­test con­firmed our diag­nosis. Oral and paren­teral potas­sium ­reverse the symp­toms. Monitoring of thy­roid func­tion is ­also impor­tant to pre­vent fur­ther ­attacks.