Thyrotoxic Periodic Paralysis in a Young Hispanic Male With Newly Diagnosed Grave's Disease

Thyrotoxic periodic paralysis (TPP) is a unique cause of hypokalemia from transcellular shift into muscle in the setting of active thyrotoxicosis. It is essential to recognize TPP, given the specific management considerations, which would otherwise easily go unaddressed. TPP can also be clinically indistinguishable from other causes of hypokalemia. In particular, familial periodic paralysis can present similar to TPP. This case illustrates a young Hispanic male who presented with paralysis and was found to be hypokalemic. Patient was also found to have thyromegaly with further testing consistent with Grave's disease, despite no hyperthyroid symptoms. Ultimately, identifying TPP early will allow for swift and appropriate treatment, avoid unnecessary interventions and testing, and reduce cost of care.