The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.
Laboratory Tests to Determine the Cause of Hypokalemia and Paralysis
Abstract
BACKGROUND: Hypokalemia and paralysis may be due to a short-term shift of potassium into cells in hypokalemic periodic paralysis (HPP) or due to a large deficit of potassium in non-HPP. Failure to make a distinction between HPP and non-HPP may lead to improper management. Therefore, we evaluated the diagnostic value of spot urine tests in patients with hypokalemia and paralysis during 3 years. METHODS: Before therapy, the urine potassium concentration, potassium-creatinine ratio, and transtubular potassium concentration gradient were determined in a second voided urine sample. RESULTS: Forty-three patients with hypokalemia and paralysis were identified: 30 had HPP and 13 had non-HPP. There was no significant difference in the plasma potassium or bicarbonate concentrations and in the pH of arterial blood between the 2 groups. All but 2 patients in the non-HPP group had urine potassium concentration values less than 20 mmol/L. Although the potassium concentration was significantly lower in the HPP group, there was some overlap. In contrast, the transtubular potassium concentration gradient and potassium-creatinine ratio differentiated patients with HPP vs non-HPP. Although only a mean +/- SD of 63 +/- 36 mmol of potassium chloride was administered in the patients with HPP, rebound hyperkalemia (>5 mmol/L) occurred in 19 (63%) of these 30 patients. CONCLUSIONS: Calculating the transtubular potassium concentration gradient and potassium-creatinine ratio provided a simple and reliable test to distinguish HPP from non-HPP. Minimal potassium chloride supplementation should be given to avoid rebound hyperkalemia in patients with HPP.
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“The precipitating factors of TPP reported in the literature included high carbohydrate ingestion, strenuous exercise, trauma, acute upper respiratory tract infection (URI), high-salt diet, emotional stress, exposure to cold, alcohol ingestion, menstruation, and use of drugs such as corticosteroids, epinephrine, acetazolamide, and non-steroidal anti-inflammatory drugs (2, 3, 14, 22, 23, 24).”
From A 10-year analysis of thyrotoxic periodic paralysis in 135 patients: focus on symptomatology and precipitants (2013) · cites this paper as [2]
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Gitelman's syndrome revisited: An evaluation of symptoms and health-related quality of life
Cruz, D. N., Shaer, A. J., BIA, M. J., Lifton, R. P., & Simon, D. B. (2001) · Kidney International · doi:10.1046/j.1523-1755.2001.059002710.x · Cited by 329
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Thyrotoxic Periodic Paralysis in the United States Report of 7 Cases and Review of the Literature
OBER, K. P. (1992) · Medicine · doi:10.1097/00005792-199205000-00001 · Cited by 289
Clinical presentation of genetically defined patients with hypokalemic salt-losing tubulopathies
Peters, M. M. C. G., Jeck, N., Reinalter, S. C., Leonhardt, A., Tönshoff, B., Klaus, G., Konrad, M., & Seyberth, H. W. (2002) · The American Journal of Medicine · doi:10.1016/s0002-9343(01)01086-5 · Cited by 259
Clinical and Metabolic Features of Thyrotoxic Periodic Paralysis in 24 Episodes
Manoukian, M. A., Foote, J. A., & Crapo, L. M. (1999) · Archives of Internal Medicine · doi:10.1001/archinte.159.6.601 · Cited by 255
Internal Potassium Balance and the Control of the Plasma Potassium Concentration
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Hypokalemic paralyses: A review of the etiologies, pathophysiology, presentation, and therapy
Stedwell, R. E., Allen, K., & Binder, L. S. (1992) · The American Journal of Emergency Medicine · doi:10.1016/0735-6757(92)90048-3 · Cited by 186
Pathophysiology of potassium absorption and secretion by the human intestine
Agarwal, R., Afzalpurkar, R. G., & Fordtran, J. S. (1994) · Gastroenterology · doi:10.1016/0016-5085(94)90184-8 · Cited by 178
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Lin, S.-H. (2005) · Mayo Clinic Proceedings · doi:10.4065/80.1.99 · Cited by 254
Self-citationHydrocarbon toxicity: A review
Tormoehlen, L. M., Tekulve, K., & Nañagas, K. (2014) · Clinical Toxicology · doi:10.3109/15563650.2014.923904 · Cited by 218
Pathophysiology and management of hypokalemia: a clinical perspective
Unwin, R. J., Luft, F. C., & Shirley, D. G. (2011) · Nature Reviews Nephrology · doi:10.1038/nrneph.2010.175 · Cited by 215
Mechanism of Thyrotoxic Periodic Paralysis
Lin, S.-H., & Huang, C.-L. (2012) · Journal of the American Society of Nephrology · doi:10.1681/asn.2012010046 · Cited by 174
Self-citation
Metadata
- Authors
- Lin, S.-H., Lin, Y.-F., Chen, D.-T., Chu, P., Hsu, C.-W., & Halperin, M. L.
- Affiliations
- Tri-Service General Hospital (TW)
- National Defense Medical Center (TW)
- University of Alabama at Birmingham (US)
- University of Toronto (CA)
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2004-07-26
- Volume
- 164
- Issue
- 14
- Pages
- 1561
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2128467090
- Cited by
- 167
- References
- 34
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 6 · 2023: 11 · 2022: 8 · 2021: 8 · 2020: 14 · 2019: 8 · 2018: 9 · 2017: 9 · 2016: 2 · 2015: 6 · 2014: 5 · 2013: 9 · 2012: 15
- FWCI
- 5.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Potassium and Related Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Ion Transport and Channel Regulation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- hypokalemic periodic paralysis, hypokalemia, paralysis, potassium chloride supplementation, differential diagnosis
- MeSH terms
- Adult, Creatinine, Diagnosis, Differential, Female, Humans, Hydrogen-Ion Concentration, Hypokalemia, Male, Potassium, Potassium Chloride, Paralysis, Hyperkalemic Periodic
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