CASE REPORT - THYROTOXIC PERIODIC PARALYSIS - a case report and review of the literature

Thyrotoxic periodic paralysis (TPP) is an uncommon disorder characterized by simultaneous thyrotoxicosis, hypokalaemia, and paralysis and is the most common acquired form of periodic paralysis. It is usually associated with low plasma potassium levels and is often precipitated by physical activity or ingestion of carbohydrates. We presented a 35-year-old man with hyperthyroidism who admitted applied to the emergency department with an episode of flaccid quadriparalysis following oral diclophenac sodium usage for lumbar disk hernia and the review of the literature on this subject. Physical and laboratory examination revealed sinus tachycardia, diffuse toxic goiter, flaccid quadriparalysis, a low serum potassium level (1.51 mmol/L), ST segment depression, coincidental horseshoe kidney. Potassium chloride was admitted via both parenteral and orally. Meanwhile antithyroid treatment (propylthiouracil and propranolol) was also given. Early diagnosis is important for planning antithyroid treatment, protecting the patient from further episodes of paralysis and avoidance of precipitating factors. In our patient, electrolyte imbalance appeared secondary to polyuria and vomiting, serious pain and physical stress may have triggered TTP.