Thyrotoxic hypokalemic periodic paralysis due to Graves’ disease in 2 adolescents
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Thyrotoxic periodic paralysis (TPP) is a notable and potentially lethal complication of thyrotoxicosis, and Graves’ disease is the most common cause of TPP. TPP is commonly reported in Asian males between 20–40 years of age, but it is rare in children and adolescents. We report 2 Korean adolescents (a 16-year-old male and a 14-year-old female) with episodes of TPP who were previously diagnosed with Graves’ disease. These 2 patients presented with lower leg weakness in the morning after waking up. They were diagnosed with TPP-associated with thyrotoxicosis due to Graves’ disease. After they were initially treated with potassium chloride and antithyroid drugs, muscle paralysis improved and an euthyroid state without muscle paralytic events was maintained during follow-up. Therefore, clinicians should consider TPP when patients have sudden paralysis and thyrotoxic symptoms such as goiter, tachycardia, and hypertension.
Abstract
Thyrotoxic periodic paralysis (TPP) is a notable and potentially lethal complication of thyrotoxicosis, and Graves’ disease is the most common cause of TPP. TPP is commonly reported in Asian males between 20–40 years of age, but it is rare in children and adolescents. We report 2 Korean adolescents (a 16-year-old male and a 14-year-old female) with episodes of TPP who were previously diagnosed with Graves’ disease. These 2 patients presented with lower leg weakness in the morning after waking up. They were diagnosed with TPP-associated with thyrotoxicosis due to Graves’ disease. After they were initially treated with potassium chloride and antithyroid drugs, muscle paralysis improved and an euthyroid state without muscle paralytic events was maintained during follow-up. Therefore, clinicians should consider TPP when patients have sudden paralysis and thyrotoxic symptoms such as goiter, tachycardia, and hypertension.
참고문헌 (20)
- Dunlap HF, "A syndrome resembling familial periodic paralysis occurring in the course of exophthalmic goiter", Endocrinology, 15, pp.541~546 (1931)
- Loh KC, "Thyrotoxic periodic paralysis complicated by near-fatal ventricular arrhythmias", Singapore Med J, 46, pp.88~89 (2005)
- Kelley DE, "Thyrotoxic periodic paralysis. Report of 10 cases and review of electromyographic findings", Arch Intern Med, 149, pp.2597~2600 (1989)
- 정세영, "Thyrotoxic periodic paralysis as initial manifestation of Graves' disease in a 16-year-old Korean adolescent", Annals of Pediatric Endocrinology & Metabolism, 19(3), pp.169~173 (2014), 대한소아내분비학회
- Nayak B, "Thyrotoxicosis and thyroid storm", Endocrinol Metab Clin North Am, 35, pp.663~686 (2006)
- 오상보, "Thyrotoxic Periodic Paralysis Associated with Transient Thyrotoxicosis Due to Painless Thyroiditis", Journal of Korean Medical Science, 27(7), pp.822~826 (2012), 대한의학회[DOI]
- Kung AW, "Clinical review: thyrotoxic periodic paralysis:a diagnostic challenge", J Clin Endocrinol Metab, 91, pp.2490~2495 (2006)
- Ryan DP, "Mutations in potassium channel Kir2.6cause susceptibility to thyrotoxic hypokalemic periodic paralysis", Cell, 140, pp.88~98 (2010)
- Li X, "The clinical and genetic features in a cohort of mainland Chinese patients with thyrotoxic periodic paralysis", BMC Neurol, 15, pp.38~ (2015)
- Park S, "Association of KCNJ2 genetic variants with susceptibility to thyrotoxic periodic paralysis in patients with Graves'disease", Exp Clin Endocrinol Diabetes, 125, pp.75~78 (2017)
- Barahona MJ, "Thyrotoxic periodic paralysis: a case report and literature review", Clin Med Res, 7, pp.96~98 (2009)
- Falhammar H, "Thyrotoxic periodic paralysis: clinical and molecular aspects", Endocrine, 43, pp.274~284 (2013)
- Guerra M, "Androgens stimulate preoptic area Na+,K+-ATPase activity in male rats", Neurosci Lett, 78, pp.97~100 (1987)
- Chakrabarti S, "Normokalemic thyrotoxic periodic paralysis with preserved reflexes- a unique case report", J Clin Diagn Res, 9, pp.OD05~OD06 (2015)
- Ko GT, "Thyrotoxic periodic paralysis in a Chinese population", QJM, 89, pp.463~468 (1996)
- Pothiwala P, "Analytic review: thyrotoxic periodic paralysis: a review", J Intensive Care Med, 25, pp.71~77 (2010)
- Manoukian MA, "Clinical and metabolic features of thyrotoxic periodic paralysis in 24episodes", Arch Intern Med, 159, pp.601~606 (1999)
- 안문배, "16세 청소년에서 발생한 갑상샘중독 주기성 마비 1례", Annals of Pediatric Endocrinology & Metabolism, 17(2), pp.117~121 (2012), 대한소아내분비학회[DOI]
- 위정국, "Etiology of Hypokalemic Paralysis in Korea: Data from a Single Center", Electrolytes & Blood Pressure, 10(1), pp.18~25 (2012), 전해질고혈압연구회[DOI]
- 조태희, "A Case of Thyrotoxic Periodic Paralysis in 17-Year-Old Adolescent", 대한소아신경학회지, 21(2), pp.68~72 (2013), 대한소아신경학회
