Case 4-2012

February 2012 in “ The New England Journal of Medicine ”

Eugene P. Rhee, James A. Scott, Anand S. Dighe

thyrotoxic periodic paralysis hyperthyroidism Graves' disease thyroid hormone thyrotropin potassium chloride methimazole metoprolol

TLDR Early diagnosis and treatment of TPP can prevent complications.

A 37-year-old man presented with severe muscle pain, weakness, and weight loss, which were found to be due to marked hypokalemia. His symptoms, including episodic weakness and acute paralysis, were consistent with thyrotoxic periodic paralysis (TPP) associated with hyperthyroidism, specifically Graves' disease. Laboratory tests confirmed elevated thyroid hormone levels and low thyrotropin levels. Treatment with potassium chloride, methimazole, and metoprolol normalized his potassium levels and improved his condition. The case underscored the importance of early diagnosis and management of TPP to prevent complications.

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