Noninvasive ventilator prevents intubation in thyrotoxic hypokalemic periodic paralysis-associated respiratory failure: A case report and literature review
Thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism, often presents with limb muscle paralysis, hypokalemia with elevated-free T3, T4, and low thyroid-stimulating hormone (TSH). We herein reported an unusual presentation of TPP with acute hypercapnic respiratory failure. A...
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| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Tzu Chi Medical Journal |
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| Online Access: | http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2021;volume=33;issue=1;spage=91;epage=95;aulast=Hung |
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| author | Shu-Ya Hung Wen-Jing Liu Pei-Chan Wu Mei-Chen Yang Yao-Kuang Wu Chou-Chin Lan |
| author_facet | Shu-Ya Hung Wen-Jing Liu Pei-Chan Wu Mei-Chen Yang Yao-Kuang Wu Chou-Chin Lan |
| author_sort | Shu-Ya Hung |
| collection | DOAJ |
| description | Thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism, often presents with limb muscle paralysis, hypokalemia with elevated-free T3, T4, and low thyroid-stimulating hormone (TSH). We herein reported an unusual presentation of TPP with acute hypercapnic respiratory failure. A 28-year-old female had complaints of nausea and vomiting. Laboratory investigations showed a serum potassium level of 1.2 mEq/L. Thyroid function test revealed the TSH level of 0.021 μlU/mL and free T4 at 2.01 ng/dL. She suddenly suffered from dyspnea and drowsiness. Acute hypercapnic respiratory failure with CO2retention was found. Noninvasive ventilation was used. Rapid correction of hypokalemia and administration of propylthiouracil, propranolol, and 5% Lugol's solution were performed. After the normalization of potassium levels, the patient's respiratory pattern stabilized and noninvasive ventilator (NIV) use was discontinued. Respiratory failure is an unusual but lethal complication of TPP. Rapid correction of hypokalemia and temporarily NIV can successfully avoid endotracheal intubation for respiratory failure. |
| format | Article |
| id | doaj-art-7085794a5cfb4566bb097827741b2ca8 |
| institution | DOAJ |
| issn | 1016-3190 2223-8956 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Tzu Chi Medical Journal |
| spelling | doaj-art-7085794a5cfb4566bb097827741b2ca82025-08-20T03:19:12ZengWolters Kluwer Medknow PublicationsTzu Chi Medical Journal1016-31902223-89562021-01-01331919510.4103/tcmj.tcmj_248_19Noninvasive ventilator prevents intubation in thyrotoxic hypokalemic periodic paralysis-associated respiratory failure: A case report and literature reviewShu-Ya HungWen-Jing LiuPei-Chan WuMei-Chen YangYao-Kuang WuChou-Chin LanThyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism, often presents with limb muscle paralysis, hypokalemia with elevated-free T3, T4, and low thyroid-stimulating hormone (TSH). We herein reported an unusual presentation of TPP with acute hypercapnic respiratory failure. A 28-year-old female had complaints of nausea and vomiting. Laboratory investigations showed a serum potassium level of 1.2 mEq/L. Thyroid function test revealed the TSH level of 0.021 μlU/mL and free T4 at 2.01 ng/dL. She suddenly suffered from dyspnea and drowsiness. Acute hypercapnic respiratory failure with CO2retention was found. Noninvasive ventilation was used. Rapid correction of hypokalemia and administration of propylthiouracil, propranolol, and 5% Lugol's solution were performed. After the normalization of potassium levels, the patient's respiratory pattern stabilized and noninvasive ventilator (NIV) use was discontinued. Respiratory failure is an unusual but lethal complication of TPP. Rapid correction of hypokalemia and temporarily NIV can successfully avoid endotracheal intubation for respiratory failure.http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2021;volume=33;issue=1;spage=91;epage=95;aulast=Hungacute respiratory failurehypokalemianoninvasive ventilatorthyrotoxicosis periodic paralysis |
| spellingShingle | Shu-Ya Hung Wen-Jing Liu Pei-Chan Wu Mei-Chen Yang Yao-Kuang Wu Chou-Chin Lan Noninvasive ventilator prevents intubation in thyrotoxic hypokalemic periodic paralysis-associated respiratory failure: A case report and literature review Tzu Chi Medical Journal acute respiratory failure hypokalemia noninvasive ventilator thyrotoxicosis periodic paralysis |
| title | Noninvasive ventilator prevents intubation in thyrotoxic hypokalemic periodic paralysis-associated respiratory failure: A case report and literature review |
| title_full | Noninvasive ventilator prevents intubation in thyrotoxic hypokalemic periodic paralysis-associated respiratory failure: A case report and literature review |
| title_fullStr | Noninvasive ventilator prevents intubation in thyrotoxic hypokalemic periodic paralysis-associated respiratory failure: A case report and literature review |
| title_full_unstemmed | Noninvasive ventilator prevents intubation in thyrotoxic hypokalemic periodic paralysis-associated respiratory failure: A case report and literature review |
| title_short | Noninvasive ventilator prevents intubation in thyrotoxic hypokalemic periodic paralysis-associated respiratory failure: A case report and literature review |
| title_sort | noninvasive ventilator prevents intubation in thyrotoxic hypokalemic periodic paralysis associated respiratory failure a case report and literature review |
| topic | acute respiratory failure hypokalemia noninvasive ventilator thyrotoxicosis periodic paralysis |
| url | http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2021;volume=33;issue=1;spage=91;epage=95;aulast=Hung |
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