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SAT449 Clinical Characteristics Of Patients With Thyrotoxic Periodic Paralysis; An Experience From A Tertiary Care Hospital

Disclosure: T. Park: None. I. Goak: None. H. Jin: None. K. Lee: None. Y. Kim: None. Backgrounds: Thyrotoxic periodic paralysis (TPP) is a life-threatening complication characterized recurrent episodes of hypokalemia and muscle weakness in the setting of thyrotoxicosis. The present study aimed to des...

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Autores principales: Sun Park, Tae, Goak, Insun, Jin, Heung-Yong, Ae Lee, Kyung, Ji Kim, Yu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10555046/
http://dx.doi.org/10.1210/jendso/bvad114.1924
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author Sun Park, Tae
Goak, Insun
Jin, Heung-Yong
Ae Lee, Kyung
Ji Kim, Yu
author_facet Sun Park, Tae
Goak, Insun
Jin, Heung-Yong
Ae Lee, Kyung
Ji Kim, Yu
author_sort Sun Park, Tae
collection PubMed
description Disclosure: T. Park: None. I. Goak: None. H. Jin: None. K. Lee: None. Y. Kim: None. Backgrounds: Thyrotoxic periodic paralysis (TPP) is a life-threatening complication characterized recurrent episodes of hypokalemia and muscle weakness in the setting of thyrotoxicosis. The present study aimed to describe clinical manifestation and outcome of patients admitted for TPP in emergency department (ED). Methods: This retrospective study analyzed 42 patients with TPP who were admitted ED from January 2000 through December 2020 in a single tertiary referral hospital. Their clinical characteristics were reviewed retrospectively. Results: 42 patients with TPP were identified. The mean age of the patients was 35.0±12.4 years; all were males. The month in which the most patients occurred paralysis symptoms was February (16.7%), followed by October (14.3%). 5 patients had a history of severe exertion, 7 patients had ingested a heavy carbohydrate meal, one patient had an infection, 5 patients had ingested alcohol, but more than half of the patients (57.1%) were without a precipitating cause. TPP was the first presentation of thyrotoxicosis in 85.7% of patients. The most common cause of thyrotoxicosis in TPP patients was Graves' disease (88.1%). At the time of admission, the mean potassium level was 2.77±0.93 mmol/L (reference, 3.5-5.5), mean ionized calcium level was 1.17±0.15 mmol/L (1.13-1.32), mean Free T4 level was 43.36±16.92 pmol/L (11.5-22.7). About half of the patients (47.6%) suffered at least one further attack of TPP. 28 patients (66.7%) diagnosed with Graves’ disease had anti-thyroid drugs alone and 5 patients (11.9%) with thyrotoxic relapses eventually underwent radioactive iodine therapy. None of the patients underwent surgery. Conclusions: TPP can be the presenting feature of previously undiagnosed thyrotoxicosis and should be considered in the differential diagnosis in patients presenting with acute onset of motor paralysis. At the time of the TPP attack, a detailed interview and inquiry with a thorough physical examination usually provide clues to the diagnosis. Presentation: Saturday, June 17, 2023
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spelling pubmed-105550462023-10-06 SAT449 Clinical Characteristics Of Patients With Thyrotoxic Periodic Paralysis; An Experience From A Tertiary Care Hospital Sun Park, Tae Goak, Insun Jin, Heung-Yong Ae Lee, Kyung Ji Kim, Yu J Endocr Soc Thyroid Disclosure: T. Park: None. I. Goak: None. H. Jin: None. K. Lee: None. Y. Kim: None. Backgrounds: Thyrotoxic periodic paralysis (TPP) is a life-threatening complication characterized recurrent episodes of hypokalemia and muscle weakness in the setting of thyrotoxicosis. The present study aimed to describe clinical manifestation and outcome of patients admitted for TPP in emergency department (ED). Methods: This retrospective study analyzed 42 patients with TPP who were admitted ED from January 2000 through December 2020 in a single tertiary referral hospital. Their clinical characteristics were reviewed retrospectively. Results: 42 patients with TPP were identified. The mean age of the patients was 35.0±12.4 years; all were males. The month in which the most patients occurred paralysis symptoms was February (16.7%), followed by October (14.3%). 5 patients had a history of severe exertion, 7 patients had ingested a heavy carbohydrate meal, one patient had an infection, 5 patients had ingested alcohol, but more than half of the patients (57.1%) were without a precipitating cause. TPP was the first presentation of thyrotoxicosis in 85.7% of patients. The most common cause of thyrotoxicosis in TPP patients was Graves' disease (88.1%). At the time of admission, the mean potassium level was 2.77±0.93 mmol/L (reference, 3.5-5.5), mean ionized calcium level was 1.17±0.15 mmol/L (1.13-1.32), mean Free T4 level was 43.36±16.92 pmol/L (11.5-22.7). About half of the patients (47.6%) suffered at least one further attack of TPP. 28 patients (66.7%) diagnosed with Graves’ disease had anti-thyroid drugs alone and 5 patients (11.9%) with thyrotoxic relapses eventually underwent radioactive iodine therapy. None of the patients underwent surgery. Conclusions: TPP can be the presenting feature of previously undiagnosed thyrotoxicosis and should be considered in the differential diagnosis in patients presenting with acute onset of motor paralysis. At the time of the TPP attack, a detailed interview and inquiry with a thorough physical examination usually provide clues to the diagnosis. Presentation: Saturday, June 17, 2023 Oxford University Press 2023-10-05 /pmc/articles/PMC10555046/ http://dx.doi.org/10.1210/jendso/bvad114.1924 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Thyroid
Sun Park, Tae
Goak, Insun
Jin, Heung-Yong
Ae Lee, Kyung
Ji Kim, Yu
SAT449 Clinical Characteristics Of Patients With Thyrotoxic Periodic Paralysis; An Experience From A Tertiary Care Hospital
title SAT449 Clinical Characteristics Of Patients With Thyrotoxic Periodic Paralysis; An Experience From A Tertiary Care Hospital
title_full SAT449 Clinical Characteristics Of Patients With Thyrotoxic Periodic Paralysis; An Experience From A Tertiary Care Hospital
title_fullStr SAT449 Clinical Characteristics Of Patients With Thyrotoxic Periodic Paralysis; An Experience From A Tertiary Care Hospital
title_full_unstemmed SAT449 Clinical Characteristics Of Patients With Thyrotoxic Periodic Paralysis; An Experience From A Tertiary Care Hospital
title_short SAT449 Clinical Characteristics Of Patients With Thyrotoxic Periodic Paralysis; An Experience From A Tertiary Care Hospital
title_sort sat449 clinical characteristics of patients with thyrotoxic periodic paralysis; an experience from a tertiary care hospital
topic Thyroid
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10555046/
http://dx.doi.org/10.1210/jendso/bvad114.1924
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