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Annals of Clinical Biochemistry

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This version was published on 1 September 2009
Ann Clin Biochem 2009;46:423-425
doi:10.1258/acb.2009.009012
© 2009 Association for Clinical Biochemistry

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Case Reports

Thyrotoxic periodic paralysis due to excessive L-thyroxine replacement in a Caucasian man

M J Hannon, L A Behan and A Agha


Academic Department of Endocrinology, Beaumont Hospital/RCSI Medical School, Dublin 9, Ireland


Corresponding author: Dr Amar Agha, Academic Department of Endocrinology, Beaumont Hospital, Dublin 9, Ireland. Email: amaragha{at}beaumont.ie


Thyrotoxic periodic paralysis is a potentially fatal complication of hyperthyroidism, more common in Asian races, which is defined by a massive intracellular flux of potassium. This leads to profound hypokalaemia and muscle paralysis. Although the paralysis is temporary, it may be lethal if not diagnosed and treated rapidly, as profound hypokalaemia may induce respiratory muscle paralysis or cardiac arrest. The condition is often misdiagnosed in the west due to its comparative rarity in Caucasians; however it is now increasingly described in Caucasians and is also being seen with increasing frequency in western hospitals due to increasing immigration and population mobility. Here we describe the case of a patient with panhypopituitarism due to a craniopharyngioma, who developed thyrotoxic periodic paralysis due to excessive L-thyroxine replacement. This disorder has been described in Asian subjects but, to our knowledge, thyrotoxic periodic paralysis secondary to excessive L-thyroxine replacement has never been described in Caucasians.


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