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First case study of periodic hypokalemic thyreotoxic paresis with partial respiratory insufficiency and concomitant sinus bradycardia

Erstbeschreibung einer periodischen hypokaliämischen thyreotoxischen Parese mit respiratorischer Partialinsuffizienz und gleichzeitiger Sinusbradykardie

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Zusammenfassung

Wir beschreiben den Fall eines 29-jährigen tschetschenischen Flüchtlings mit einer periodischen hypokaliämischen thyreotoxischen Tetraparese (PHTP). Der Patient hatte neben einer respiratorischen Partialinsuffizienz auch eine Sinusbradykardie. In der Literatur gibt es mehrere Fallbeschreibungen von Thyreotoxikose in Verbindung mit Bradykardie. Wir konnten erstmals eine PHTP in Kombination mit einer Sinusbradykardie beobachten. Die PHTP ist in Mitteleuropa ein selten zu beobachtendes Krankheitsbild. Wie in unserem Fall war die Diagnose erschwert durch das gleichzeitige Vorhandensein einer Bradykardie unter manifester Hyperthyreose bei Immunthyreopathie Typ Morbus Basedow.

Summary

This report describes the case of a 29-year-old Chechen refugee with periodic hypokalemic thyreotoxic tetraparesis (PHTP). Besides a partial respiratory insufficiency, the patient was also presented with sinus bradycardia. Medical literature describes several cases of thyreotoxicosis in combination with bradycardia. For the first time, we were able to observe a case of PHTP in combination with sinus bradycardia. PHTP is rarely seen in central Europe. In this case establishing a final diagnosis was difficult because of the concomitant presence of bradycardia and Graves' disease.

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References

  • Lin SH. Thyrotoxic periodic paralysis. Mayo Clin Proc, 80: 99–105, 2005

    Article  PubMed  Google Scholar 

  • Liu YC, Tsai WS, Chau T, et al. Acute hypercapnic respiratory failure due to thyrotoxic periodic paralysis. Am J Med Sci, 327: 264–267, 2004

    Article  PubMed  Google Scholar 

  • Hager W. Sinus bradycardia in hyperthyreotic crisis? Dtsch Med Wochenschr, 103: 1324, 1978

    PubMed  CAS  Google Scholar 

  • Gonzalez de Cossio A. Presentation of a case of thyrotoxicosis with bradycardia due to auriculoventricular block of two to one type. Rev Invest Clin, 8: 399–402, 1956

    PubMed  CAS  Google Scholar 

  • Kramer LD, Cole JP, Messenger JC, et al. Cardiac dysfunction in a patient with familial hypokalemic periodic paralysis. Chest, 75: 189–192, 1979

    Article  PubMed  CAS  Google Scholar 

  • Hsu YJ, Lin YF, Chau T, et al. Electrocardiographic manifestations in patients with thyrotoxic periodic paralysis. Am J Med Sci, 326: 128–132, 2003

    Article  PubMed  Google Scholar 

  • Kung AW. Clinical review: Thyrotoxic periodic paralysis: a diagnostic challenge. J Clin Endocrinol Metab, 91: 2490–2495. 2006

    Article  PubMed  CAS  Google Scholar 

  • Ober KP. Thyrotoxic periodic paralysis in the United States. Report of 7 cases and review of the literature. Medicine (Baltimore), 71: 109–120, 1992

    CAS  Google Scholar 

  • Crane Mg. Periodic paralysis associated with hyperthyroidism. Cardiologia, 92: 285–288, 1960

    PubMed  Google Scholar 

  • Chatot-Henry C, Smadja D, Longhi R, et al. Thyrotoxic periodic paralysis: two new cases in Blacks Rev Med Interne, 21: 632–634, 2000

    Article  PubMed  CAS  Google Scholar 

  • Kelley DE, Gharib H, Kennedy FP, et al. Thyrotoxic periodic paralysis. Report of 10 cases and review of electromyographic findings. Arch Intern Med, 149: 2597–2600, 1989

    Article  PubMed  CAS  Google Scholar 

  • Chan A, Shinde R, Chow CC, et al. In vivo and in vitro sodium pump activity in subjects with thyrotoxic periodic paralysis. BMJ, 303(6810): 1096–1099, 1991

    Article  PubMed  CAS  Google Scholar 

  • Lam KS, Yeung RT, Benson EA, et al. Erythrocyte sodium-potassium pump in thyrotoxic periodic paralysis. Aust N Z J Med, 19: 6–10, 1989

    PubMed  CAS  Google Scholar 

  • Kung AW, Lau KS, Fong GC, et al. Association of novel single nucleotide polymorphisms in the calcium channel alpha 1 subunit gene (Ca(v)1.1) and thyrotoxic periodic paralysis. J Clin Endocrinol Metab, 89: 1340–1345, 2004

    Article  PubMed  CAS  Google Scholar 

  • Vogel D, Schwegler B, Schmidt J, et al. Hypokalemic thyrotoxic periodic paralysis following rice consumption. Dtsch Med Wochenschr, 132: 1510–1512, 2007

    Article  PubMed  CAS  Google Scholar 

  • Shulkin D, Olson BR, Levey GS. Thyrotoxic periodic paralysis in a Latin-American taking acetazolamide. Am J Med Sci, 297: 337–338, 1989

    Article  PubMed  CAS  Google Scholar 

  • Atienza Morales MP, Jiménez García JA, Beato Pérez JL, et al. Amiodarone as cause of periodic thyrotoxic hypopotasemic paralysis. Rev Clin Esp, 206: 598–599, 2006

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Werner Nagele.

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Nagele, W., Hörmann, J. & Nagele, J. First case study of periodic hypokalemic thyreotoxic paresis with partial respiratory insufficiency and concomitant sinus bradycardia. Wien Med Wochenschr 159, 156–159 (2009). https://doi.org/10.1007/s10354-009-0644-1

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  • DOI: https://doi.org/10.1007/s10354-009-0644-1

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