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Cited by 70Thyroid Disorders and TreatmentsPotassium and Related DisordersCardiac electrophysiology and arrhythmias

The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.

Electrocardiographic Manifestations in Patients with Thyrotoxic Periodic Paralysis

Hsu, Yu-Juei, Lin, Yuh-Feng, Chau, Tom, Lin, Shih-Hua, Liou, Jun-Ting, Kuo, Shi-Wen·2003·The American Journal of the Medical Sciences
DOI 10.1097/00000441-200309000-00004
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Abstract

Background Thyrotoxic periodic paralysis (TPP) commonly precedes the overt symptoms and signs of hyperthyroidism and may be misdiagnosed as other causes of paralysis (non-TPP). Because the cardiovascular system is very sensitive to elevation of thyroid hormone, we hypothesize that electrocardiographic manifestations may aid in early diagnosis of TPP.Methods We retrospectively identified 54 patients who presented to the emergency department (ED) with hypokalemic paralysis during a 3.5-year period. Thirty-one patients had TPP and 23 patients had non-TPP, including sporadic periodic paralysis, distal renal tubular acidosis, diuretic use, licorice intoxication, primary hyperaldosteronism, and Bartter-like syndrome. Electrocardiograms during attacks were analyzed for rate, rhythm, conduction, PR interval, QRS voltage, ST segment, QT interval, U waves, and T waves.Results There were no significant differences in age, sex distribution, and plasma K+ concentration between the TPP and non-TPP groups. Plasma phosphate was significantly lower in TPP than non-TPP. Heart rate, PR interval, and QRS voltage were significantly higher in TPP than non-TPP. Forty-five percent of TPP patients had first-degree atrioventricular block compared with 13% in the non-TPP group. There were no significant differences in QT shortening, ST depression, U wave appearance, or T wave flattening between the 2 groups.Conclusion Relatively rapid heart rate, high QRS voltage, and first-degree AV block are important clues suggesting TPP in patients who present with hypokalemia and paralysis.

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Crossref · 10.1097/00000441-200309000-00004

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  1. Clark, 1985, Ventricular tachycardia associated with hypophosphatemia, Nutr Int, 11, 102

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Metadata

Authors
Hsu, Y.-J., Lin, Y.-F., Chau, T., Lin, S.-H., Liou, J.-T., & Kuo, S.-W.
Affiliations
Tri-Service General Hospital (TW)
Corresponding author
Lin, Shih-Hua
ORCID
Venue
The American Journal of the Medical Sciences
Publisher
Elsevier BV
Published
2003-09
Volume
326
Issue
3
Pages
128-132
ISSN
0002-9629 (ISSN-L)
DOI
10.1097/00000441-200309000-00004
OpenAlex
W2059261397
Cited by
70
References
31
Citations by year
2026: 1 · 2025: 1 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 2 · 2017: 2 · 2015: 3 · 2014: 2 · 2013: 3 · 2012: 10
FWCI
2.38
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The American Journal of the Medical Sciences (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Nephrology › Potassium and Related Disorders
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords
thyrotoxic periodic paralysis, electrocardiographic findings, hypokalemia, hypokalemic paralysis, first-degree atrioventricular block, hyperthyroidism, plasma phosphate, QRS voltage, heart rate
MeSH terms
Acidosis, Renal Tubular, Adult, Age Factors, Electrocardiography, Female, Humans, Hyperaldosteronism, Hypokalemia, Male, Middle Aged, Paralyses, Familial Periodic, Phosphates, Potassium, Retrospective Studies, Sensitivity and Specificity, Sex Factors, Thyroid Diseases, Thyrotoxicosis, Time Factors

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