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VOLUME 22 , ISSUE 5 ( 2018 ) > List of Articles


Thyrotoxic hypokalemic periodic paralysis

Satyendra Sonkar, Neeraj Singh

Keywords : Hyperthyroidism, hypokalemia, quadriparesis

Citation Information : Sonkar S, Singh N. Thyrotoxic hypokalemic periodic paralysis. Indian J Crit Care Med 2018; 22 (5):378-380.

DOI: 10.4103/ijccm.IJCCM_369_17

License: CC BY-ND 3.0

Published Online: 01-02-2015

Copyright Statement:  Copyright © 2018; The Author(s).


Hypokalemia is a serious and life-threatening clinical condition. We present a case of a 45-year-old male, with known hyperthyroidism presenting with profound tremor, irritability, quadriparesis, and labored breathing since morning, on the day of admission. Arterial blood gas analysis showed severe hypokalemia. Patient's vital was stabilized and patient's oxygen saturation was maintained on oxygen inhalation. Intravenous potassium chloride infusion was administered with regular monitoring of vitals and electrolytes. Patient's symptoms improved. Thyroid function testing showed high free T3 (tri-iodothyronine) and free T4 (thyroxine) with low thyroid-stimulating hormone concentration in the serum, indicating thyrotoxic hypokalemic periodic paralysis. Treatment with antithyroid drug carbimazole resulted in an improvement during the follow-up visit. Hypokalemia is believed to be a consequence of a massive shift due to increased sodium–potassium–adenosine triphosphatase (Na+K+ATPase) pump activity in the presence of elevated thyroid hormones.

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