Abstract

MOMBIEDRO-SEGARRA, J et al. Thyrotoxic periodic paralysis: a case report. Sanid. Mil. [online]. 2021, vol.77, n.3, pp.137-142.  Epub Jan 17, 2022. ISSN 1887-8571.  https://dx.doi.org/10.4321/s1887-85712021000300004.

Thyrotoxic periodic paralysis (PPT) is a specific disorder which is presented by the triad: acute hypokalemia, thyrotoxicosis, and bilateral paralysis usually of the lower extremities. It is a life-threatening complication of hyperthyroidism and is triggered by a rapid intracellular change in potassium, leading to the appearance of a state of seriousness that requires treatment in an emergency department or admission to an intensive care unit and that, it can usually be potentially reversible when it is detected at an early stage.

It should be noted that, despite the prevalence of hyperthyroidism diagnosis in women, PPT occurs more frequently in men, as well as having a higher incidence in population of Asian descents.

Factors such as intense physical activity, consumption of carbohydrate-rich diets or continued use of steroids, among others, can precipitate the appearance of PPT. Early recognition of PPT is crucial and necessary to establish a prompt diagnosis and effective initial treatment.

Reversing symptoms of muscular paralysis and hypokalemia should be the fundamental pillars on which the treatment of PPT is focused in order to avoid possible added complications, such as bronchoaspiration and cardiac arrhythmias, among others. Parallel to the treatment of the acute process, measures will be applied to prevent future attacks by restoring the patient to an optimal euthyroid state.

A case of thyrotoxic periodic paralysis diagnosed during the pandemic period due to the SARS-CoV 2 virus presented in the Intensive Medicine service of the Hospital Central de la Defensa “Gómez Ulla”. Assessing the possible logistical and health limitations existing during that period at an out-of-hospital level that could lead to the development of this clinical picture but which finally progressed well.

Keywords : Thyrotoxic periodic paralysis; hypokalemia; thyrotoxicosis; bilateral paralysis; hyperthyroidism; cardiac arrhythmias.

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