An Interesting case of hypokalemic paralysis

Abstract

A 40-yr-old woman presented with complaints
of weakness of both upper and
lower limbs lasting for two days. She was
found to have hypokalaemic periodic paralysis.
She had thyroid goitre on examination
and was a known hyperthyroid on
treatment. However, on investigating it
was found that she also had urinary potassium
loss with metabolic acidosis and
a reduced ability to acidify urine. The coexistence
of distal renal tubular acidosis
(RTA) was confirmed. There was no evidence
of xerostomia or xerophthalmia,
although rheumatoid factor and anti nuclear
antibody were positive. The purpose
of presenting this case is to show
that in view of the strong male predominance
of thyrotoxic periodic paralysis
(TPP), female patients should be thoroughly
investigated for possible additional
precipitating factors, particularly
when there are atypical metabolic features.