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Cited by 160Thyroid Disorders and TreatmentsPotassium and Related DisordersThyroid and Parathyroid Surgery

Thyrotoxic periodic paralysis in a Chinese population

Ko, G.T.C., Chow, C.C., Yeung, V.T.F., Chan, H.H.L., LI, J.K.Y., Cockram, C.S.·1996·QJM
DOI 10.1093/qjmed/89.6.463
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Abstract

We retrospectively evaluated the characteristics of adult patients admitted with thyrotoxic hypokalaemic periodic paralysis in Hong Kong. From 1984 to 1993, 45 Chinese adult patients were admitted with acute limb weakness, plasma potassium < or = 3.5 mmol/l and thyrotoxicosis confirmed by laboratory investigations. All but one were male. Seventy-five percent of attacks occurred between 9pm and 9am. Half of the attacks occurred between July and October (49.1%), most commonly in August (20%). Mean (+/- SEM) plasma potassium on admission was 2.17 +/- 0.08 mmol/l (range 1.1-3.5). In 15 episodes (27.3%), plasma potassium on recovery exceeded 5.0 mmol/l, while in three episodes (5.5%), potassium exceeded 6.0 mmol/l. No patient had a positive family history of thyrotoxic periodic paralysis. Only 28.9% had a known history of thyrotoxicosis before their first presentation with periodic paralysis. Twenty-seven (60%) had clinical evidence of thyrotoxicosis. Although all were biochemically thyrotoxic, 11.4% had only a mild degree of thyrotoxicosis (suppressed thyroid-stimulating hormone, high free thyroxine, but normal free triiodothyronine). One quarter of the patients had a normal erythrocyte zinc concentration, indicating either a short history of thyrotoxicosis or transient thyrotoxicosis. The diagnosis of thyrotoxic hypokalaemic paralysis should always be considered in Chinese patients with acute muscle weakness, especially in young males. Absence of clinical thyrotoxicosis does not exclude the diagnosis. Plasma potassium should be monitored carefully during treatment to prevent rebound hyperkalaemia.

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  • One study showed that 65% of TPP patients had initial thyrotoxic symptoms and 60% were clinically thyrotoxic at presentation.

    “One study showed that 65% of TPP patients had initial thyrotoxic symptoms and 60% were clinically thyrotoxic at presentation [5].”

    From A Case of Thyrotoxic Periodic Paralysis: "I Can't Move!" (2023) · cites this paper as [5]

  • Thyrotoxic periodic paralysis typically affects Asian males between the ages of 20 and 40.

    “It typically affects Asian males between the ages of 20-40 [4, 5, 6].”

    From A Case of Thyrotoxic Periodic Paralysis: "I Can't Move!" (2023) · cites this paper as [5]

  • The underlying hyperthyroidism in TPP is often subtle, causing difficulty in early diagnosis.

    “The underlying hyperthyroidism is often subtle causing difficulty in early diagnosis.”

    From Thyrotoxic Periodic Paralysis: Clinical Challenges (2014) · cites this paper as [6]

  • Hyperthyroidism is more common in females, with a female-to-male ratio of 9:1.

    “The male to female ratio ranges from 17 : 1 to 70 : 1 despite the fact that hyperthyroidism is more common in females (female-to-male ratio of 9 : 1) [6].”

    From Thyrotoxic Periodic Paralysis: Clinical Challenges (2014) · cites this paper as [6]

  • The male to female ratio of TPP ranges from 17:1 to 70:1.

    “The male to female ratio ranges from 17 : 1 to 70 : 1 despite the fact that hyperthyroidism is more common in females (female-to-male ratio of 9 : 1) [6].”

    From Thyrotoxic Periodic Paralysis: Clinical Challenges (2014) · cites this paper as [6]

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Authors
Ko, G. T. C., Chow, C. C., Yeung, V. T. F., Chan, H. H. L., LI, J. K. Y., & Cockram, C. S.
Affiliations
Chinese University of Hong Kong (HK)
ORCID
Venue
QJM
Publisher
Oxford University Press (OUP)
Published
1996-06-01
Volume
89
Issue
6
Pages
463-468
ISSN
  • 0033-5622 (ISSN-L)
  • 1460-2725
  • 1460-2393
DOI
10.1093/qjmed/89.6.463
OpenAlex
W2131711651
Cited by
160
References
38
Citations by year
2026: 2 · 2025: 3 · 2024: 6 · 2023: 3 · 2022: 5 · 2021: 6 · 2020: 9 · 2019: 2 · 2018: 2 · 2017: 5 · 2016: 4 · 2015: 6 · 2014: 4 · 2013: 6 · 2012: 12
FWCI
1.61
Type
journal article
Language
en
Open access
closed
Locations
  • QJM (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Potassium and Related Disorders
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
thyrotoxic periodic paralysis, thyrotoxicosis, hypokalemia, Chinese adults, erythrocyte zinc, thyroid-stimulating hormone, free thyroxine, free triiodothyronine, Hong Kong
MeSH terms
Adult, Female, Hong Kong, Humans, Hypokalemia, Male, Middle Aged, Paralysis, Periodicity, Retrospective Studies, Thyrotoxicosis, Incidence

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