SHM Converge Scientific Abstract ePoster Gallery-A Grave Case of Weakness

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The document describes a case of thyrotoxic periodic paralysis (TPP), a rare but potentially dangerous complication of hyperthyroidism. TPP can cause sudden generalized muscle weakness due to severe hypokalemia, and prompt recognition is important because it can lead to serious cardiopulmonary complications.<br /><br />A previously healthy 23-year-old man developed progressive weakness over one month. He first visited an emergency department with profound weakness and was found to have a potassium level of 2.3 mmol/L; his symptoms improved after potassium repletion. He later had recurrent severe weakness and was admitted to the hospital, where potassium was 2.0 mmol/L. At that time, he was also found to have an undetectable TSH, elevated T4, and positive TSH immunoglobulin, confirming Graves’ disease as the cause of thyrotoxicosis. His weakness resolved with potassium replacement and treatment of the thyroid condition using methimazole and propranolol.<br /><br />After discharge, he was readmitted to the ICU with another episode of weakness following a carbohydrate-rich meal, illustrating how high carbohydrate intake can trigger paralysis by increasing insulin release and further activating the Na-K-ATPase pump. The case emphasizes that in patients with periodic paralysis or diffuse weakness, clinicians should consider thyroid dysfunction even if thyroid symptoms are subtle. Prevention of recurrence includes treating the underlying hyperthyroidism, correcting electrolytes, and advising patients to avoid triggers such as high-carbohydrate meals and strenuous exercise.

Asset Subtitle

LaBrin Joshua

Meta Tag

Author List Danielle Johnson, LaBrin Joshua, Leah Stinson

Category Clinical Vignettes

Concept Thyrotoxic Periodic Paralysis

Concept Muscle Weakness

Concept Hyperthyroidism

Concept Hypokalemia

Concept Na-K-ATPase

Distinguished Non-Finalist

Presenter Organization University of Utah

Presenting Author LaBrin Joshua

Track Adult

Keywords

thyrotoxic periodic paralysis

hyperthyroidism

Graves disease

hypokalemia

muscle weakness

potassium repletion

methimazole

propranolol

carbohydrate-rich meal

Na-K-ATPase

Thyrotoxic Periodic Paralysis

Muscle Weakness

Hyperthyroidism

Hypokalemia

Na-K-ATPase