Thyrotoxic periodic paralysis: reports of seven patients presenting with weakness in an Asian emergency department
Open accessAbstract
OBJECTIVES: This study was done to describe the features of thyrotoxic periodic paralysis in young Asian men. METHODS: Seven male patients were enlisted who presented to the emergency department over a period of three years with weakness and paralysis in the morning. RESULTS: Initial electrolyte studies revealed hypokalaemia in these patients, and later thyroid function tests confirmed thyrotoxicosis for all. Only two of these patients had clinical symptoms and signs of thyrotoxicosis, the others being asymptomatic. CONCLUSIONS: Early morning paralysis can be the first manifestation of hyperthyroidism in Asian men, without the other more typical symptoms of weight loss, increased appetite, excitability, sweaty palms or goitre. Treatment to a euthyroid state will ameliorate the syndrome.
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Previous reports indicate that nearly 50% of TPP patients had only subtle signs/symptoms of thyrotoxicosis, without systematic assessment.
“According to previous reports, nearly 50% of TPP patients had only subtle signs/symptoms of thyrotoxicosis, albeit without systematic assessment (14, 15, 16, 36).”
From A 10-year analysis of thyrotoxic periodic paralysis in 135 patients: focus on symptomatology and precipitants (2013) · cites this paper as [16]
The Discussion reports that five of seven patients had no clinical signs or symptoms of thyrotoxicosis, supporting the point that TPP can present with few or no overt thyroid symptoms. It does not support the claimed figure of nearly 50%, and Patients and Methods says the patients were examined for signs and symptoms of thyroid overactivity, contrary to the suggestion that this report lacked assessment. (LLM, conf=0.87)
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Cites
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Effects of potassium supplementation on the recovery of thyrotoxic periodic paralysis
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- Authors
- Goh, S. H.
- Corresponding author
- Goh, S H.
- Venue
- Emergency Medicine Journal
- Publisher
- BMJ
- Published
- 2002-01-01
- Volume
- 19
- Issue
- 1
- Pages
- 78-79
- ISSN
- 1351-0622 (ISSN-L)
- 1472-0205
- 1472-0213
- PMC
- PMC1725752
- OpenAlex
- W1970636863
- Cited by
- 32
- References
- 11
- Citations by year
- 2025: 1 · 2023: 1 · 2019: 1 · 2018: 1 · 2016: 1 · 2015: 1 · 2013: 2 · 2012: 1
- FWCI
- 1.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Emergency Medicine Journal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Potassium and Related Disorders
- Keywords
- thyrotoxic periodic paralysis, hyperthyroidism, hypokalemia, muscle weakness, Asian men, emergency department presentation
- MeSH terms
- Adult, Humans, Male, Middle Aged, Paralyses, Familial Periodic, Thyrotoxicosis, Asian People
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