Thyrotoxic periodic paralysis: A case report and literature review
Open accessAbstract
Thyrotoxic periodic paralysis (TPP) is a rare presentation of thyrotoxicosis most commonly associated with Graves' disease. It is rare in Caucasians, but it affects approximately 2% of Asians (occurring in those of Chinese, Japanese, Vietnamese, Filipino, and Korean descent) with thyrotoxicosis of any cause. Typical thyrotoxic features may be absent despite biochemical thyrotoxicosis. Hypokalemia and muscle paralysis are the result of an acute intracellular shift of potassium and not due to total body potassium deficiency. TPP is a self-limiting condition that is easily corrected by treatment of the thyrotoxicosis. We present a case of a Filipino man, aged 47 years, who presented to the emergency department with acute bilateral lower extremity weakness and hypokalemia who was subsequently diagnosed with TPP due to Graves' disease.
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TL;DR
Thyrotoxic periodic paralysis (TPP) is a rare complication of thyrotoxicosis, most often associated with Graves’ disease, caused by an acute intracellular shift of potassium rather than total-body potassium deficiency. The paper reports a 47-year-old Filipino man with acute bilateral lower extremity weakness and hypokalemia who was diagnosed with TPP due to Graves’ disease and improved after potassium correction.
Key findings
- The patient presented with hypokalemia of 1.9 mmol/L (normal 3.5–5.3 mmol/L); potassium correction was achieved within 36 hours and correlated with resolution of lower limb weakness. At discharge, potassium was 4.3 mmol/L without potassium supplementation.
- Thyroid testing showed biochemical thyrotoxicosis: TSH <0.01 mIU/L (normal 0.35–4.9 mIU/L), free thyroxine 21.9 pmol/L (normal 0.0–19.0 pmol/L), and free tri-iodothyronine 11.3 pmol/L (normal 2.76–6.45 pmol/L). Radioactive iodine uptake was 35% at 4 hours (normal 5%–14%) and 88% at 24 hours (normal 8%–30%) with homogeneous distribution, consistent with Graves’ disease; TRAb was negative.
- The paper states TPP is rare in Caucasians but affects approximately 2% of Asians with thyrotoxicosis of any cause, and that typical thyrotoxic features may be absent despite biochemical thyrotoxicosis.
- Literature review notes that attacks may be precipitated by high-carbohydrate meals, vigorous exercise, alcohol, trauma, infection, stress, insulin, and diuretics; treatment includes potassium replacement, nonselective beta-blockers if poor response, and definitive correction of thyrotoxicosis. In most cases, <50 mEq of potassium is required, and >90 mEq in 24 hours can result in rebound hyperkalemia.
Methods
- Design: case report and literature review.
- Data/sample: a single 47-year-old Filipino man presenting to the emergency department with acute bilateral lower extremity weakness and hypokalemia, subsequently diagnosed with TPP due to Graves’ disease.
- Main analysis: clinical examination, laboratory testing including thyroid function and potassium, electrocardiogram, radioactive iodine thyroid uptake scan, and TRAb testing; management included intravenous fluids, intravenous and oral potassium replacement, discontinuation of hydrochlorothiazide, and initiation of methimazole. No formal systematic review methods are described.
Limitations
- Stated limitations: Not stated in the paper.
- Evident from the text: this is a single case report, so findings are not generalizable and no comparison group or formal follow-up beyond discharge planning is reported.
- Evident from the text: the literature review is narrative rather than systematic, and the diagnosis of Graves’ disease was supported by radioactive iodine uptake despite a negative TRAb, which the paper notes does not exclude Graves’ disease.
Model-written summary. Check it against the paper before relying on it.
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Cites
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Claims the paper makes
0 of 32 cited sources checked · 0 supported · 0 flagged
- Findingown data
The patient's TSH receptor antibody test was negative.
“Testing for thyroid stimulating hormone (TSH) receptor antibodies (TRAb) was negative.”
Quote in the paperNot a substantial claim - Premisecitation
In thyrotoxic periodic paralysis, hypokalemia and paralysis arise from potassium moving acutely into cells, not from a whole-body potassium deficit.
“Hypokalemia and muscle paralysis are the result of an acute intracellular shift of potassium and not due to total body potassium deficiency.”
- Also stated in: § Discussion · plain
“The end result from both of these processes is increased intracellular shift of potassium and depleted extracellular potassium stores.4”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [4]
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- Also stated in: § Discussion · plain
- Premisecitation
In thyrotoxic periodic paralysis, overt thyrotoxic signs and symptoms may be missing even when biochemistry shows thyrotoxicosis.
“Typical thyrotoxic features may be absent despite biochemical thyrotoxicosis.”
- Also stated in: § Discussion · hedged
“In patients with TPP, thyrotoxic symptoms and signs may be subtle or absent, as in our case, and the presenting complaint may be of weakness, paralysis, or other symptoms of hypokalemia.2,8”
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- cites [8]
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- Also stated in: § Discussion · hedged
- Premisecitation
In thyrotoxic periodic paralysis, patients may first report weakness, paralysis, or other hypokalemia symptoms.
“In patients with TPP, thyrotoxic symptoms and signs may be subtle or absent, as in our case, and the presenting complaint may be of weakness, paralysis, or other symptoms of hypokalemia.2,8”
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- Premisecitation
Beta-blockers like propranolol can reduce adrenergic overstimulation of the sodium-potassium ATPase pump in thyrotoxic periodic paralysis when potassium replacement works poorly.
“Nonselective beta-blockers (eg, propranolol) can be used to attenuate the adrenergic overstimulation of the sodiumpotassium ATPase pump if there is a poor response to potassium replacement.2,5”
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- Premisecitation
In thyrotoxic periodic paralysis, muscle weakness severity tracks directly with the degree of hypokalemia.
“In patients with TPP, the severity of muscle weakness is directly correlated to the degree of hypokalemia.5”
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- Interpretationreasoning
Since the patient had no other known triggers, hydrochlorothiazide initiation was deemed the most probable cause of his thyrotoxic periodic paralysis.
“As there was no history of high carbohydrate or alcohol ingestion, vigorous exercise, stress, trauma, or infection in our patient, the initiation of hydrochlorothiazide was the most likely trigger for TPP in his case.”
Quote in the paperSubstantial claim - Premisecitation
In thyrotoxic periodic paralysis, muscle cell membranes become hyperpolarized, which produces paralysis and clinical weakness.
“Eventually there is hyperpolarization of the muscle cell membranes, leading to muscle paralysis and clinical weakness.7”
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- Premisecitation
Curing thyrotoxic periodic paralysis definitively requires treating the thyrotoxic state with anti-thyroid drugs, radioactive iodine ablation, or thyroidectomy.
“Definitive treatment of TPP requires correction of the thyrotoxic state including with anti-thyroid medication, radioactive iodine thyroid ablation, or thyroidectomy.2,5,6”
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- Premisereasoning
Thyroid function testing can separate thyrotoxic periodic paralysis from other hypokalemic periodic paralysis causes.
“Assessing thyroid function distinguishes TPP from other causes of hypokalemic periodic paralysis, as outlined in Table 2.”
Quote in the paperSubstantial claim - Premisecitation
A negative TRAb result does not rule out Graves' disease, since a small minority of patients lack overt symptoms, goiter, or classic eye and skin findings.
“While his TRAb was negative, this does not exclude a diagnosis of Graves' disease, which can be absent in a small minority of patients without overt symptoms, goiter, or classic ophthalmopathy and dermopathy, as in this case.9”
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- Premisecitation
Thyroid hormone induces sodium-potassium ATPase gene transcription by activating the thyroid response element in cell nuclei.
“Thyroid hormone activates the thyroid response element in cellular nuclei, thereby inducing Na/K ATPase gene transcription.4”
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- Premisecitation
Intravenous potassium replacement may correct hypokalemia and restore muscle strength faster than oral replacement in thyrotoxic periodic paralysis.
“Intravenous potassium replacement may result in quicker correction of hypokalemia and faster recovery of muscle strength compared to oral replacement.6”
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- Premisecitation
The differential diagnosis for thyrotoxic periodic paralysis includes other causes of hypokalemic periodic paralysis and weakness, such as familial hypokalemic periodic paralysis, myasthenia gravis, Guillain-Barré syndrome, inflammatory myopathies, transverse myelitis, cord compression, and electrolyte abnormalities.
“TPP is rare, and other potential diagnoses should be considered including familial hypokalemic periodic paralysis, myasthenia gravis, Guillain-Barre Syndrome, infectious and inflammatory myopathies, transverse myelitis, cord compression, and other electrolyte abnormalities. 2”
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- Interpretationreasoning
For this patient, other causes of weakness were ruled out through history, physical examination, and additional tests.
“These causes can be excluded based on the history, physical examination, and other investigations.”
Quote in the paperSubstantial claim - Premisecitation
Radioactive iodine uptake plus thyroid scan remain the gold standard for distinguishing thyrotoxicosis causes, with sensitivity and specificity above 95%.
“RAIU and thyroid scan remain the gold standard to differentiate causes of thyrotoxicosis, with sensitivity and specificity over 95%. 10”
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- May combine two claims. 19
- Classified as probably not a substantial claim. 3
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Findingown dataA 47-year-old Filipino man came in with sudden weakness in both legs and low potassium, and was later diagnosed with thyrotoxic periodic paralysis from Graves' disease.
“We present a case of a Filipino man, aged 47 years, who presented to the emergency department with acute bilateral lower extremity weakness and hypokalemia who was subsequently diagnosed with TPP due to Graves' disease.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataWhen discharged, the patient had a potassium level of 4.3 mmol/L and was not taking potassium supplements.
“At discharge, his potassium level was 4.3 mmol/L without potassium supplementation.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataThe patient's ECG revealed sinus tachycardia without U waves or ST changes.
“An electrocardiogram showed sinus tachycardia and no U waves or ST changes.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe patient's serum potassium was 1.9 mmol/L, below the normal range of 3.5-5.3 mmol/L.
“Laboratory studies completed in the emergency department revealed hypokalemia of 1.9 mmol/L (normal 3.5-5.3mmol/L).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe patient's potassium normalized within 36 hours, and this matched the return of strength in his legs.
“Correction of his potassium level was achieved within 36 hours, and this correlated with a resolution of his lower limb weakness.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe patient's thyroid scan supported Graves' disease, with iodine uptake of 35% at 4 hours and 88% at 24 hours.
“A radioactive iodine thyroid uptake scan followed the laboratory testing, and this was consistent with Graves' disease.The scan showed increased radioactive iodine uptake of 35% at 4 hours (normal is 5%-14%) and 88% at 24 hours (normal is 8%-30%) with homogenous distribution of the tracer.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe patient's thyroid tests showed biochemical thyrotoxicosis even though physical examination found no hyperthyroid signs.
“Despite there being no features of hyperthyroidism on physical examination, thyroid function testing was consistent with biochemical thyrotoxicosis as shown in Table 1.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe patient improved with moderate potassium doses and needed no beta-blockers.
“Our patient responded well to moderate doses of potassium without the need for beta blockers.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationThe precise mechanism of thyrotoxic periodic paralysis remains unclear, but it is believed to involve thyroid hormone stimulating the sodium-potassium ATPase pump both directly and indirectly.
“The exact mechanism is unknown, but it is thought to arise from direct and indirect stimulation of the Na/K ATPase pump by thyroid hormone.2,6”
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Interpretationown dataThe patient's thyrotoxic periodic paralysis was ascribed to Graves' disease, with hydrochlorothiazide initiation as a possible trigger.
“The patient was discharged with a diagnosis of TPP due to Graves' disease, possibly triggered by the initiation of hydrochlorothiazide.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationThyrotoxic periodic paralysis is self-limited and improves when the underlying thyrotoxicosis is treated.
“TPP is a self-limiting condition that is easily corrected by treatment of the thyrotoxicosis.”
- Also stated in: § Discussion · plain
“Definitive treatment of TPP requires correction of the thyrotoxic state including with anti-thyroid medication, radioactive iodine thyroid ablation, or thyroidectomy.2,5,6”
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- Also stated in: § Discussion · plain
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PremisecitationThyrotoxic periodic paralysis is a rare thyrotoxicosis complication, most often linked to Graves' disease.
“Thyrotoxic periodic paralysis (TPP) is a rare presentation of thyrotoxicosis most commonly associated with Graves' disease.”
- Also stated in: § Discussion · plain
“TPP is an uncommon complication of thyrotoxicosis, most commonly associated with Graves' disease. 2”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [2]
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- Also stated in: § Discussion · plain
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PremisecitationThyrotoxic periodic paralysis is linked to genetic mutations like KCNE3 and certain leukocyte antigen subtypes, which raise sodium-potassium ATPase pump activity or alter other potassium channels in skeletal muscle.
“The development of TPP is also associated with genetic mutations (eg, KCNE3) and certain leukocyte antigen subtypes (A2BW22, AW19B17, B5, BW 46, DRw8), which increase Na/K ATPase pump activity or modify other potassium channels in skeletal muscle cells.7”
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PremisecitationTRAb tests can be negative, and their clinical performance has not been assessed in subclinical hyperthyroidism.
“However, a negative antibody test can occur, and clinical performance of TRAb testing has not been evaluated in patients with subclinical hyerperthroidism.10”
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PremisecitationThyrotoxic periodic paralysis attacks tend to hit the proximal lower limbs and can be brought on by high-carbohydrate meals, strenuous exercise, alcohol, trauma, infection, stress, insulin, and diuretics.
“Attacks of muscle paralysis preferentially affect the proximal lower extremities and may be precipitated by high carbohydrate meals, vigorous exercise, alcohol ingestion, trauma, infection, stress, and medications such as insulin and diuretics.1,2”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [1]
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PremisecitationMost thyrotoxic periodic paralysis cases need under 50 mEq of potassium, while over 90 mEq within a day can lead to rebound hyperkalemia.
“In most cases, < 50 mEq of potassium is required, and > 90 mEq in 24 hours can result in rebound hyperkalemia.8”
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InterpretationcitationThyrotoxic periodic paralysis is now uncommon in Europe and North America, but migration patterns are expected to raise its incidence.
“While TPP is currently rare in Europe and North America, current trends in human migration will likely result in a greater incidence of TTP in the future.3”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [3]
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PremisecitationThyroid hormone increases beta-adrenergic receptor sensitivity, which in turn raises sodium-potassium ATPase pump activity in skeletal muscle.
“It also increases beta-adrenergic receptor sensitivity, which itself increases Na/K ATPase pump activity in skeletal muscles.7”
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PremisecitationThyrotoxic periodic paralysis predominantly affects young and middle-aged adult men, possibly because testosterone stimulates sodium-potassium ATPase while estrogen decreases its activity.
“Young and middle aged adult men appear to be most affected by TPP, which may be explained by testosterone's stimulatory effects on the Na + -K + ATPase, unlike estrogen, which decreases its activity.5”
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InterpretationreasoningThyrotoxic periodic paralysis should be considered in patients with acute weakness or paralysis and hypokalemia, especially middle-aged men of Asian descent.
“In conclusion, TPP should be considered in all patients with muscle weakness, especially in middle aged males of Asian descent, who present with acute weakness or paralysis and hypokalemia.”
Quote in the paperSubstantial claim- Rests on an assumption: Thyrotoxic periodic paralysis is uncommon in Caucasians, yet about 2% of Asians with thyrotoxicosis of any cause develop it.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe American Thyroid Association and American Association of Clinical Endocrinologists guideline advises thyroid uptake and scan as the main differential test for thyrotoxicosis when the presentation does not clearly indicate Graves' disease.
“The joint guideline of the American Thyroid Association and the American Association of Clinical Endocrinologists recommends a thyroid uptake and scan as the primary differential diagnostic test for thyrotoxicosis when the clinical presentation of thyrotoxicosis is not diagnostic of Graves' disease.9”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [9]
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The paper relies on this without support.
Thyrotoxic periodic paralysis is uncommon in Caucasians, yet about 2% of Asians with thyrotoxicosis of any cause develop it.
“It is rare in Caucasians, but it affects approximately 2% of Asians (occurring in those of Chinese, Japanese, Vietnamese, Filipino, and Korean descent) with thyrotoxicosis of any cause.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Thyrotoxic periodic paralysis occurs in males in ratios ranging from 17:1 to 70:1.
“TPP occurs in males in ratios ranging from 17:1 to 70:1 [2, 3].”
From A Case of Thyrotoxic Periodic Paralysis: "I Can't Move!" (2023) · cites this paper as [2]
Thyroid-stimulating immunoglobulin (TSI) assay is 96% sensitive and 99% specific for Graves' disease.
“Unfortunately, we were unable to obtain a thyroid-stimulating immunoglobulin (TSI) assay, which is 96% sensitive and 99% specific for Graves’ disease [7].”
From Thyrotoxic Periodic Paralysis With Hypokalemia: A Case Study (2023) · cites this paper as [7]
Cites
Bahn, R. S., Burch, H. B., Cooper, D. S., Garber, J. R., Greenlee, M. C., Klein, I., Laurberg, P., McDougall, I. R., Montori, V. M., Rivkees, S. A., et al. (2011) · Endocrine Practice · doi:10.4158/ep.17.3.456 · Cited by 1,098 · see citing works
Thyrotoxic Periodic Paralysis: A Diagnostic Challenge
Kung, A. W. C. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-0356 · Cited by 371 · see citing works
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 · Cited by 160 · see citing works
Chang, C.-C., Cheng, C.-J., Sung, C.-C., Chiueh, T.-S., Lee, C.-H., Chau, T., & Lin, S.-H. (2013) · European Journal of Endocrinology · doi:10.1530/eje-13-0381 · Cited by 114 · see citing works
Scappaticcio, L., Trimboli, P., Keller, F., Imperiali, M., Piccardo, A., & Giovanella, L. (2019) · Clinical Endocrinology · doi:10.1111/cen.14130 · Cited by 76 · see citing works
Cesur, M., Bayram, F., Temel, M. A., Ozkaya, M., Kocer, A., Ertorer, M. E., Koc, F., Kaya, A., & Gullu, S. (2008) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2007.03014.x · Cited by 45 · see citing works
Thyrotoxic, hypokalaemic periodic paralysis: Polynesians, an ethnic group at risk
Elston, M. S., Orr‐Walker, B., Dissanayake, A. M., & Conaglen, J. V. (2007) · Internal Medicine Journal · doi:10.1111/j.1445-5994.2007.01313.x · Cited by 34 · see citing works
Thyrotoxic periodic paralysis: case report and review of the literature
Vardhan Garla, V., Gunturu, M., Reddy Kovvuru, K., & Abdul Salim, S. (2018) · Electronic Physician · doi:10.19082/7174 · Cited by 20 · see citing works
Thyrotoxic hypokalaemic paralysis in a Black man
Salifu, M. O. (2001) · QJM · doi:10.1093/qjmed/94.11.659 · Cited by 15 · see citing works
Munir, I., Mehmood, T., Islam, K., Soni, L., & McFarlane, S. I. (2020) · American Journal of Medical Case Reports · doi:10.12691/ajmcr-7-7-5 · Cited by 9 · see citing works
Flagged first, then by citations
1 of the 11 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Stroke-mimicking unilateral hypokalemic paralysis and literature review
Liu, X., Han, K., & Lu, X. (2022) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2022.04.042 · Cited by 10 · see citing works
Hypokalemic periodic paralysis as the first sign of thyrotoxicosis- a rare case report from Somalia
Mohamed, H. N., Ghedi, A. K. A., Ozturk, S., Jeele, M. O. O., & Bashir, A. M. (2023) · Thyroid Research · doi:10.1186/s13044-023-00158-4 · Cited by 7 · see citing works
“THPP is common in Asian men, including Chinese, Japanese, Vietnamese, Filipinos, and Koreans, and Graves’ disease is the most common cause of hyperthyroidism associated with THPP [8].”
BackgroundThyrotoxic Hypokalemic Periodic Paralysis: Pathophysiological Mechanisms
Qing, G., Zakaria, W. N. A., Rom, F. Z. M., Nik, W. N. F. H. W., Zulkeflee, H. A., & Rahim, S. N. A. (2025) · Endocrinology and Metabolism · doi:10.3803/enm.2025.2554 · Cited by 5 · see citing works
Murashita, M., Wada, N., Baba, S., Sugawara, H., Miyoshi, A., & Obara, S. (2022) · Endocrinology Diabetes and Metabolism Case Reports · doi:10.1530/edm-22-0236 · Cited by 5 · see citing works
Alrashedi, F. S. (2025) · Cureus · doi:10.7759/cureus.98814 · Cited by 4 · see citing works
(2023) · PubMed Central · doi:10.7759/cureus.46272 · Cited by 4 · see citing works
Unveiling Thyrotoxic Periodic Paralysis: A Rare Hyperthyroid Complication
Puente, R. C., Moreno, P. D. A., Muñoz, A. M. B., Luis, A., & Sáenz, C. P. C. (2025) · Cureus · doi:10.7759/cureus.83280 · Cited by 4 · see citing works
“Additionally, adrenergic stimulation by thyroid hormones increases the activity of the Na-K ATPase pump, further increasing the shift of serum potassium into the cell [3,4].”
Insulin-induced severe thyrotoxic periodic paralysis: A case report
Wang, Y., & Li, J. (2024) · World Journal of Clinical Cases · doi:10.12998/wjcc.v13.i7.101214 · Cited by 3 · see citing works
Thyrotoxic Periodic Paralysis With Hypokalemia: A Case Study
Mebane, N. B., Khan, A., Bevinal, M., & Davis, E. (2023) · Cureus · doi:10.7759/cureus.40757 · Cited by 3 · see citing works
“Unfortunately, we were unable to obtain a thyroid-stimulating immunoglobulin (TSI) assay, which is 96% sensitive and 99% specific for Graves’ disease [7].”
BackgroundA Case of Thyrotoxic Periodic Paralysis: "I Can't Move!"
Basnet, A., Goyal, N., Tiwari, K., Kansakar, S., & Gautam, S. (2023) · Cureus · doi:10.7759/cureus.34301 · Cited by 2 · see citing works
“Despite thyrotoxicosis affecting females nine times more than males, TPP occurs in males in ratios ranging from 17:1 to 70:1 [2, 3].”
BackgroundThyrotoxic periodic paralysis: a rare cause of periodic paralysis – a case report
Poudel, R., Baral, S., Adhikari, S., Dhungana, U., Pradhan, A., Baral, S., Kumal, K., & Thakuri, S. B. H. (2023) · Annals of Medicine and Surgery · doi:10.1097/ms9.0000000000000105 · Cited by 2 · see citing works
Parálisis periódica tirotóxica, una serie de casos
Sánchez, J. L. B., Guerra, L. I. G., Martínez, I. A. P., Mesa, J. S. N., & Rodríguez, L. J. V. (2024) · Neurología Argentina · doi:10.1016/j.neuarg.2024.04.003 · Cited by 1 · see citing works
Graves’ Disease: From Pathophysiology to Novel Therapeutic Aspects
Kostoglou‐Athanassiou, I., Athanassiou, L., & Athanassiou, P. (2025) · IntechOpen eBooks · doi:10.5772/intechopen.1012026 · Cited by 1 · see citing works
Intravenous Iodinated Contrast Induced Thyrotoxic Periodic Paralysis: A Case Report
Alrushaid, S., & Alessa, T. (2022) · Case Reports in Endocrinology · doi:10.1155/2022/3615312 · Cited by 1 · see citing works
Xu, Y., Zhao, L., Dong, J., et al. (2023) · Brain Sciences · doi:10.3390/brainsci13071049
“Thyroid hormone (TH) directly and indirectly stimulates the Na/K ATPase pump and eventually contributes to hyperpolarization of the muscle cell membranes [14].”
BackgroundThyrotoxic Periodic Paralysis after Surgery: A Case Report and Literature Review
Wouters, C., Willems, M., Mullens, A., & Meersman, A. (2023) · Emergency Medicine - Open Journal · doi:10.17140/emoj-9-172
Üstay, Ö., Ertörer, M. E., Selek, A., Yılmaz, M., Apaydın, T., Yalın, G. Y., Salman, S., Sezer, H., Deyneli, O., Ersoy, C., et al. (2024) · Akademisyen Kitabevi eBooks · doi:10.37609/akya.2879
Nguyen, L. A., Cazin, M., & Miles, J. D. (2024) · Cureus · doi:10.7759/cureus.65309
“Within the Asian population, it has been primarily characterized in Chinese, Japanese, Vietnamese, Filipino, and Korean ethnicities [2,3].”
Background(2000) · Time to knit · doi:10.1016/s1959-5182(23)46880-8
Andronikof, M. (2025) · EMC - Urgence · doi:10.1016/s1241-8234(25)50513-8
Graves’ disease and hypokalemic periodic paralysis: A case series
Arguinchona, J., Allen, N., Kumar, A., et al. (2025) · The American Journal of Medicine · doi:10.1016/j.amjmed.2025.07.031
Hyperthyroidism in Disguise: A Case of New-Onset Atrial Fibrillation and Acute Reversible Paralysis
Shahid, U., Ashin, N. T., & Dara, S. I. (2025) · JCEM Case Reports · doi:10.1210/jcemcr/luaf193
“However, a closer review of the literature reveals that the vast majority of reported cases are from East Asian populations [1, 12-14].”
Zhao, L., He, Y., Bateer, H., et al. (2025) · Turkish Journal of Biochemistry · doi:10.1515/tjb-2025-0086
“The samples were collected by Doppler ultrasound equipment according to the North American Asymptomatic Carotid Endarterectomy Trial (NASCET) [21, 22].”
A Trajectory of Thyroid Function: From Thyrotoxic Paralysis to Post-ablative Hypothyroidism
Ganesan, J. A., & Ekpemandu, N. M. (2025) · Cureus · doi:10.7759/cureus.96924
Andronikof, M. (2025) · EMC - Urgenze · doi:10.1016/s1286-9341(25)51100-6
Clinical features and advances in the genetics of periodic paralysis
罗曼, Liu, B., Xu, J., & Meng, D. (2026) · PeerJ · doi:10.7717/peerj.20840
“Even PP phenotypes can routinely indicate thyrotoxicity ( Allard et al., 2023 ; Cui & Zhang, 2022 ; Patel & Ladak, 2021 ).”
Meomartino, L., Selvatico, G., Aimaretti, G., et al. (2026) · L Endocrinologo · doi:10.1007/s40619-026-01820-3
“È una condizione ra-ra che colpisce più frequentemente giovani maschi asiatici, con una prevalenza stimata di circa il 2% tra gli individui di origine asiatica affetti da tireotossicosi [1, 2].”
InfluentialThyrotoxic periodic paralysis: a case report
Miranda-Pacheco, J., Camargo, L., Arrieta, A. B., Arango, C. A., & Moscote, R. F. (2025) · Revista Ciencias Biomédicas · doi:10.32997/rcb-2025-5951
- Authors
- Patel, M., & Ladak, K.
- Affiliations
- McMaster University (CA)
- Corresponding author
- Ladak, Karim
- Venue
- Clinical Medicine & Research
- Publisher
- Marshfield Clinic Research Institute
- Published
- 2021-09
- Volume
- 19
- Issue
- 3
- Pages
- 148-151
- ISSN
- 1539-4182 (ISSN-L)
- 1554-6179
- PMC
- PMC8445659
- OpenAlex
- W3200117163
- Semantic Scholar
- 44b1b7e4d489b66dfec5f89fb0f05ddc0786df4a
- Cited by
- 27
- References
- 11
- Citations by year
- 2026: 2 · 2025: 11 · 2024: 4 · 2023: 7 · 2022: 3
- FWCI
- 2.61
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Clinical Medicine & Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (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 › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Keywords
- thyrotoxic periodic paralysis, thyrotoxicosis, Graves' disease, hypokalemia, muscle weakness, intracellular potassium shift, Asian patients
- MeSH terms
- Graves Disease, Humans, Hypokalemia, Paralysis, Potassium, Thyrotoxicosis
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