Thyrotoxicosis Hypokalemic Paralysis

Abstract

One potential complication of hyperthyroidism is thyrotoxicosis hypokalemic paralysis. While young Asian males are the most commonly affected by this rare, but potentially fatal hyperthyroidism condition, it can also sporadically affect people of other ethnicities. This case study describes the case of a 33-year-old non-diabetic, non-alcoholic man who reported to the emergency room with lower-limb weakness, generalized body aches, and palpitations. Laboratory analysis revealed he had significantly low potassium levels. An ECG revealed a U wave, a prolonged Q—T interval, ST depression, and T-wave inversion. Thyrotoxicosis was confirmed to be present, as evidenced by abnormally elevated T4 and thyroid antibody levels.
Two enlarged thyroid lobes with uniform texture and distinct vascularity were observed on a thyroid ultrasound scan. Hypokalemia from this covert thyrotoxicosis resulted in paralysis, palpitations, and other symptoms. Potassium was administered intravenously, along with other drugs, to the patient as needed. This case was relatively unique; hospitals do not frequently encounter such a presentation with such clear signs that leads to an absolute diagnosis. This case study will describe how the patient's thyrotoxicosis-related hypokalemic paralysis was identified and subsequently treated with intravenous potassium.