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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Main Authors: Shu-Ya Hung, Wen-Jing Liu, Pei-Chan Wu, Mei-Chen Yang, Yao-Kuang Wu, Chou-Chin Lan
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2021-01-01
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.
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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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