Graves’ Disease Presenting with Periodic Paralysis to the Emergency Department
Thyrotoxic periodic paralysis is an infrequent manifestation of hyperthyroidism and an uncommon cause of muscle weakness in western countries. The diagnosis should be considered in the differential when a patient presents with transient and recurrent weakness associated with hypokalaemia. We present...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2018/9763452 |
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| author | Nick Si Rui Lan P. Gerry Fegan |
| author_facet | Nick Si Rui Lan P. Gerry Fegan |
| author_sort | Nick Si Rui Lan |
| collection | DOAJ |
| description | Thyrotoxic periodic paralysis is an infrequent manifestation of hyperthyroidism and an uncommon cause of muscle weakness in western countries. The diagnosis should be considered in the differential when a patient presents with transient and recurrent weakness associated with hypokalaemia. We present a case of a 26-year-old Asian male presenting with sudden onset muscle weakness affecting predominantly his lower limbs on a background of weight loss. Physical examination demonstrated symmetrical proximal muscle weakness with normal sensation and reflexes. Initial biochemical investigations revealed hypokalaemia, hypomagnesaemia, and hyperthyroidism. Intravenous electrolyte replacement was administered in the emergency department. The patient’s symptoms resolved during inpatient admission. Subsequent TSH receptor antibody testing and radionuclide thyroid scan confirmed a diagnosis of Graves’ disease. The patient was discharged on antithyroid medication with no further episodes of weakness on follow-up. Therefore, thyrotoxic periodic paralysis can be the presenting feature of previously undiagnosed Graves’ disease and should be considered in the differential diagnosis in patients presenting with weakness. |
| format | Article |
| id | doaj-art-1e228bba12d348c8a55a2ea2ed1fd17c |
| institution | Kabale University |
| issn | 2090-6501 2090-651X |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Endocrinology |
| spelling | doaj-art-1e228bba12d348c8a55a2ea2ed1fd17c2025-08-20T03:54:34ZengWileyCase Reports in Endocrinology2090-65012090-651X2018-01-01201810.1155/2018/97634529763452Graves’ Disease Presenting with Periodic Paralysis to the Emergency DepartmentNick Si Rui Lan0P. Gerry Fegan1Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, 6150, Western Australia, AustraliaFiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, 6150, Western Australia, AustraliaThyrotoxic periodic paralysis is an infrequent manifestation of hyperthyroidism and an uncommon cause of muscle weakness in western countries. The diagnosis should be considered in the differential when a patient presents with transient and recurrent weakness associated with hypokalaemia. We present a case of a 26-year-old Asian male presenting with sudden onset muscle weakness affecting predominantly his lower limbs on a background of weight loss. Physical examination demonstrated symmetrical proximal muscle weakness with normal sensation and reflexes. Initial biochemical investigations revealed hypokalaemia, hypomagnesaemia, and hyperthyroidism. Intravenous electrolyte replacement was administered in the emergency department. The patient’s symptoms resolved during inpatient admission. Subsequent TSH receptor antibody testing and radionuclide thyroid scan confirmed a diagnosis of Graves’ disease. The patient was discharged on antithyroid medication with no further episodes of weakness on follow-up. Therefore, thyrotoxic periodic paralysis can be the presenting feature of previously undiagnosed Graves’ disease and should be considered in the differential diagnosis in patients presenting with weakness.http://dx.doi.org/10.1155/2018/9763452 |
| spellingShingle | Nick Si Rui Lan P. Gerry Fegan Graves’ Disease Presenting with Periodic Paralysis to the Emergency Department Case Reports in Endocrinology |
| title | Graves’ Disease Presenting with Periodic Paralysis to the Emergency Department |
| title_full | Graves’ Disease Presenting with Periodic Paralysis to the Emergency Department |
| title_fullStr | Graves’ Disease Presenting with Periodic Paralysis to the Emergency Department |
| title_full_unstemmed | Graves’ Disease Presenting with Periodic Paralysis to the Emergency Department |
| title_short | Graves’ Disease Presenting with Periodic Paralysis to the Emergency Department |
| title_sort | graves disease presenting with periodic paralysis to the emergency department |
| url | http://dx.doi.org/10.1155/2018/9763452 |
| work_keys_str_mv | AT nicksiruilan gravesdiseasepresentingwithperiodicparalysistotheemergencydepartment AT pgerryfegan gravesdiseasepresentingwithperiodicparalysistotheemergencydepartment |