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Thyrotoxic Hypokalemic Periodic Paralysis (THPP): a challenge for the Emergency Medicine physician in Western countries. A case report

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Author(s): F. Stella | L. Gottardo | M.T. Busetto | S. Pianetti | A. Semplicini

Journal: Emergency Care Journal
ISSN 1826-9826

Volume: 8;
Issue: 1;
Start page: 13;
Date: 2012;
Original page

Keywords: Thyrotoxic Hypokalemic Periodic Paralysis | Emergency Medicine | Western countries

ABSTRACT
Thyrotoxic hypokalemic periodic paralysis (THPP) is an endocrine emergency with sudden onset of acute muscle hypo-asthenia associated with severe hypokalemia and normal acid-base balance, due to thyrotoxicosis. It may develop in patients of Asian and Native American descent, but it is very rare and undiagnosed in Western countries. Standard treatment includes β-blockers and thyrostatic drugs, but hypokalemia should not be treated with high potassium doses due to the risk of hyperkalemic rebound. Since early diagnosis and correct treatment can prevent life-threatening cardio-pulmonary complications, the emergency physician should keep in mind this rare possibility. We report a case of a 43 year old Caucasian man presenting at ED with tetraparesis as the first symptom of thyrotoxicosis with no other remarkable symptoms or signs.
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