Ventricular Fibrillation due to Severe Hypokalemia in a Patient with Thyrotoxic Periodic Paralysis

Abstract

Hypokalemic thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism. It accompanies episodes of hypokalemia and muscle weakness. In general, hypokalemia, normokalemia, and hyperkalemia can all be observed. There are generally some precipitating factors such as stress, vigorous exercise, and high carbohydrate consumption all of which make way for the occurrence of attacks. The duration of attacks range from 2-36 hours and can be shortened by potassium supplementation. Except for attacks of paralysis, it is a disease that affects totally healthy people. A 31-year-old female patient was admitted to the emergency unit with the complaints of bilateral lower and upper extremity weakness and paralysis. The patient's history and laboratory findings were consistent with our diagnosis of thyrotoxic periodic paralysis. Thyrotoxic periodic paralysis is a rare but life-threatening clinical entity. We would like to present an uncommon case of thyrotoxic periodic paralysis and along with a review the literature. Key words: Thyrotoxicosis; Hypokalemia; Hypokalemic Periodic Paralysis.

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Tirotoksik Hipokalemik Periyodik Paralizili Bir Hastada Hipokaleminin Tetiklediği Ventriküler Fibrilasyon

Abstract

Tirotoksik hipokalemik periyodik paralizi (TPP) hipertiroidinin nadir bir komplikasyonu olup, hipokalemi ve kas güçsüzlüğü atakları ile seyretmektedir. Klinik pratikte hipokalemi, normokalemi ya da hiperkalemi saptanabilir. Genellikle atakların oluşmasını tetikleyen stres, aşırı egzersiz, karbonhidrattan zengin beslenme gibi presipitan faktörler vardır. Atakların süresi ortalama 2-36 saat kadar olup gerekli durumlarda potasyum replasmanı ile bu süre daha da kısalmaktadır. Paralizi atakları dışında kişinin tamamen sağlıklı olduğu bir hastalıktır. Acil polikliniğimize başvuran 31 yaşında kadın hastanın, bacaklarında ve kollarında güçsüzlük, yürüyememe şikayetleri mevcuttu. Anamnez ve laboratuvar incelemeleri ile hastaya tirotoksik periyodik paralizi tanısı kondu. Tirotoksik periyodik paralizi nadir ancak hayatı tehdit edebilen bir klinik durumdur. Bu olgu sunumunda nadir olması nedeniyle tipik tirotoksik periyodik paralizi tanılı bir hasta literatür eşliğinde gözden geçirilip sunulmuştur. Anahtar Kelimler: Tirotoksikozis; Hipokalemi; Hipokalemik Periyodik Paralizi.

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References

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