Hypokalemic Paralysis Due to Thyrotoxicosis

Abstract

Thyrotoxicosis hypokalemic paralysis is a relatively uncommon, life-threatening complication of hyperthyroidism that is most frequently seen in young Asian males but can occur sporadically in other races. The present case report discusses a 33-year-old non-diabetic non-alcoholic male admitted to the emergency room with complaints of lower limb weakness, generalized body aches, and palpitations. Laboratory investigations showed extremely low levels of potassium. An ECG showed ST depression, T-wave inversion, a prolonged Q—T interval, and the presence of a U-wave. T4 and thyroid antibody levels were found to be abnormally raised, indicating thyrotoxicosis. On a thyroid ultrasound image, enlargement of both thyroid lobes with homogenous texture and marked vascularity was noted. This hidden thyrotoxicosis led to hypokalemia which caused paralysis, palpitations, and associated symptoms.  The patient was treated with intravenous potassium and other medications accordingly. The above-mentioned case was a unique presentation, one that was not commonly found in the hospital with such evident indications resulting in an absolute diagnosis. This case study will explore how the patient was diagnosed and managed with intravenous potassium to relieve hypokalemic paralysis caused by thyrotoxicosis.