Endocrinology and Metabolism

Case Report

A Case of Thyrotoxic Hypokalemic Periodic Paralysis Presenting as Cardiac Arrest.: Chang Ho Song, Choon Hee Chung, Young Joon Weon, Mi Deok Lee, Seong Jin Park, Young Goo Shin, Won Sik Lee; J Korean Endocr Soc. 1995;10(4):424-427. Published online November 7, 2019

1,329 View
25 Download

Abstract PDF: Periodic paralysis associated with thyrotoxicosis is characterized by intermittent flaccid paralysis of the skeletal muscle. The paralysis usually involve the skeletal muscle of the limbs, especially lower extrimities. In general, sensory function is intact. Involvement of respiratory, ocular or bulbar muscles is very rare, but bulbar and respiratoy invelvement may prove fatal. It is very rare a case that has severe clinical manifestation such as cardiac arrest. We report a case of thyrotoxic hypokalemic periodic paralysis presenting as cardiac arrest.

Original Article

Clinical Study
Thyrotoxic Periodic Paralysis and Polymorphisms of the ADRB2, AR, and GABRA3 Genes in Men with Graves Disease: Suyeon Park, Tae Yong Kim, Soyoung Sim, Seonhee Lim, Mijin Kim, Hyemi Kwon, Min Ji Jeon, Won Gu Kim, Young Kee Shong, Won Bae Kim; Endocrinol Metab. 2016;31(1):142-146. Published online March 16, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.1.142

4,792 View
40 Download
5 Web of Science
4 Crossref

Abstract PDF PubReader

Background

Thyrotoxic periodic paralysis (TPP) is a rare complication of thyrotoxicosis characterized by acute attacks of muscle weakness and hypokalemia. Recently, variation in several genes was suggested to be associated with TPP. This study evaluated the genetic predisposition to TPP in terms of the β2-adrenergic receptor (ADRB2), androgen receptor (AR), and γ-aminobutyric acid receptor α3 subunit (GABRA3) genes.

Methods

This study enrolled 48 men with Graves disease (GD) and TPP, and 48 GD patients without TPP. We compared the frequencies of candidate polymorphisms between the two groups.

Results

The frequency of the Gly16/Gly16 genotype in ADRB2 was not significantly associated with TPP (P=0.32). More CAG repeats (≥26) in the AR gene were not correlated with TPP (odds ratio [OR], 2.46; 95% confidence interval [CI], 0.81 to 8.09; P=0.08). The allele frequency of the TT genotype in the GABRA3 gene was not associated with TPP (OR, 1.83; 95% CI, 0.54 to 6.74; P=0.41).

Conclusion

The polymorphisms in the ADRB2, AR, and GABRA3 genes could not explain the genetic susceptibility to TPP in Korean men with GD.

Citations

Citations to this article as recorded by

RNASET2,GPR174, and PTPN22 gene polymorphisms are related to the risk of liver damage associated with the hyperthyroidism in patients with Graves’ disease
Qing Zhang, Shaozheng Liu, Yanxing Guan, Qingjie Chen, Qing Zhang, Xiang Min
Journal of Clinical Laboratory Analysis.2018;[Epub] CrossRef
Articles inEndocrinology and Metabolismin 2016
Won-Young Lee
Endocrinology and Metabolism.2017; 32(1): 62. CrossRef
Periodic Paralysis and Encephalopathy as Initial Manifestations of Graves’ Disease
Theocharis Tsironis, Athanasios Tychalas, Dimitrios Kiourtidis, Jannis Kountouras, Georgia Xiromerisiou, Jobst Rudolf, Georgia Deretzi
The Neurologist.2017; 22(4): 134. CrossRef
Thyrotoxic periodic paralysis
Zdeněk Doležel, Dana Novotná, Helena Schneiderová, Jan Papež, Martin Jouza
Pediatrie pro praxi.2016; 17(6): 379. CrossRef

Case Report

A Case of Thyrotoxic Periodic Paralysis with Rhabdomyolysis.: Seo Hee Lee, Seong Yeol Kim, Hae Ri Lee, Jun Goo Kang, Ohk Hyun Ryu, Chul Sik Kim, Byung Wan Lee, Seong Jin Lee, Eun Gyoung Hong, Hyeon Kyu Kim, Doo Man Kim, Jae Myung Yu, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo; J Korean Endocr Soc. 2008;23(6):425-429. Published online December 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.6.425

2,291 View
28 Download

Abstract PDF: Hyperthyroidism combined with rhabdomyolysis is extremely rare. There are only 6 reported cases of hyperthyroidism accompanied with rhabdomyolysis in the medical literature. Rhabdomyolysis is a syndrome involving the breakdown of skeletal muscle, and this causes myoglobin and intracellular protein to leak into the circulation. The causes of rhabdomyolysis include trauma, electrolyte abnormality, infection, drug, toxin and hypothyroidism. We report here on a patient who presented with thyrotoxic periodic paralysis and rhabdomyolysis with hypokalemia. He complained of lower leg paralysis along with muscle tenderness, and the laboratory findings showed elevated creatine kinase (CK) levels. After treatment by hydration, potassium replacement and drug medication, including propylthiouracil and beta-blocker, his CK levels were normalized and his symptoms were much improved. For patient with thyrotoxic periodic paralysis and muscle tenderness, the possibility of rhabdomyolysis should be clarified by examining the CK levels.

Original Article

CAG Repeats in the Androgen Receptor Polymorphism do not Correlate with Thyrotoxic Periodic Paralysis.: Won Gu Kim, Tae Yong Kim, Jung Min Kim, Yoon Soo Rhee, Hyun Jeung Choi, Won Bae Kim, Young Kee Shong; J Korean Endocr Soc. 2008;23(2):117-122. Published online April 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.2.117

2,383 View
21 Download
3 Crossref

Abstract PDF

BACKGROUND
Thyrotoxic periodic paralysis (TPP) occurs mostly in males, but no studies have addressed the role of androgen in the disease. Hyperinsulinemia can precipitate acute paralysis in TPP patients. CAG repeats in the androgen receptor (AR), an X-linked gene, correlate with serum insulin levels. AIM: To evaluate whether CAG repeats in the AR gene might predict the susceptibility to TPP in Korean male Graves' patients. METHODS: We evaluated CAG repeat length in a series of 33 male TPP patients and 48 control patients by direct sequencing of the PCR product of the AR promoter site. Control patients were male Graves' patients without a history of paralysis. RESULTS: The CAG repeat length varied from 15 to 34 (median of 23). The upper quartile of CAG length was equal to or above 26 repeats (long AR). The distribution of long AR was 0.30 in TPP and 0.15 in control patients, respectively (odds ratio, 2.51; 95% confidence interval, 0.92~6.85; P = 0.09). CONCLUSION: AR gene polymorphisms may not confer genetic susceptibility to TPP in Korean male patients with Graves' disease.

Citations

Citations to this article as recorded by

Contributions of CAG repeat length in the androgen receptor gene and androgen profiles to premature pubarche in Korean girls
Min Jae Kang, Jeong Seon Lee, Hwa Young Kim, Hae Woon Jung, Young Ah Lee, Sun Hee Lee, Ji-Young Seo, Jae Hyun Kim, Hye Rim Chung, Se Young Kim, Choong Ho Shin, Sei Won Yang
Endocrine Journal.2017; 64(1): 91. CrossRef
Thyrotoxic Periodic Paralysis and Polymorphisms of the ADRB2, AR, and GABRA3 Genes in Men with Graves Disease
Suyeon Park, Tae Yong Kim, Soyoung Sim, Seonhee Lim, Mijin Kim, Hyemi Kwon, Min Ji Jeon, Won Gu Kim, Young Kee Shong, Won Bae Kim
Endocrinology and Metabolism.2016; 31(1): 142. CrossRef
Androgen Receptor Gene CAG Repeat Polymorphism and Effect of Testosterone Therapy in Hypogonadal Men in Korea
Min Joo Kim, Jin Taek Kim, Sun Wook Cho, Sang Wan Kim, Chan Soo Shin, Kyong Soo Park, Seong Yeon Kim
Endocrinology and Metabolism.2011; 26(3): 225. CrossRef

Case Reports

A Case of Thyrotoxic Periodic Paralysis Presenting as Ventricular Tachycardia.: Woun Seok Ryu, Sang Mi Lee, Sung Jun Sim, Dong Wook Lee, Jong Dae Han, Eun A Chung, In Kwan Song, Hwan Won Choi, Dong Youb Cha, Ie Byung Park; J Korean Endocr Soc. 1999;14(3):587-591. Published online January 1, 2001

1,272 View
21 Download

Abstract PDF: sociated with hyperthyroidism occurs in 2.0% of Graves disease and is characterized by myasthenia or bilateral flaccid paralysis of lower extremity, in some cases, it may be accompanied with cardiac arrhythmias which are mostly due to hypokalemia. The most common type of cardiac arrhythmias associated with hyperthyroidism is sinus tachycardia, 1015% of patients have atrial fibrillation. Rarely, ventricular tachycardia or ventricular fibrillation develop and lead to cardiac arrest in severe case. A 26-year-old man was admitted to the hospital because of weakness of lower extremity. The initial EKG showed ventricular tachycardia. The laboratory results were, TSH 0.08 microunit/mL, free T4 4.11 ng/mL, T3 2.88 ng/mL, serum K 1.9 mEq/L. He was diagnosed as ventricular tachycardia associated with hypokalemic thyrotoxic periodic paralysis. His symptoms improved during the treatment with propylthiouracil and potassium replacement. We report a case of thyrotoxic periodic paralysis presenting as ventricular tachycardia with brief review of literatures.

A Case of Aldosteronoma Complicated with Hyperthyroidism.: Yeo Joo Kim, Mi Rim Kim, Moon Seok Nam, Hyo Young Min, Sung Ryol Kwon, Sung Wook Cho, Young Ub Cho, Yong Sung Kim; J Korean Endocr Soc. 1998;13(3):480-488. Published online January 1, 2001

1,334 View
19 Download

Abstract PDF: Primary aldosteronism is characterized by hypokalemic metabolic alkalosis, low plasma renin activity, elevated plasma aldosterone level and can be suspected in the patients with hypertension and unexplained hypokalemia. Small adrenal cortical adenomas are responsible for this syndrome in most cases. The incidence of thyrotoxic periodic paralysis ranges from 1.9 to 6.2 % in Japan. Thyrotoxic periodic paralysis usually subsides following treatment of hyperthyroidism and has good prognosis. A 56 year-old man presented with hyperthyroidism, hypertension and recurrent hypokalemia. During the treatment of hyperthyroidism, he repeatedly experienced weakness of both lower extremities. Hormonal evaluation was performed and he was found to have a 2*2*1.5 cm sized right adrenal tumor by abdominal computerized topography(CT). After right adrenalectomy, hypokalemic periodic paralysis was improved. Both thyroid and adrenal function should be comprehensively investigated in periodic paralysis. In conclusion, physicians must be aware of the possibility of primary aldosteronism in hyperthyroid patients with hypokalemic periodic paralysis. We report a case of aldosteronoma complicated with hyperthyroidism and literatures are reviewed.

First
Prev
Page of 1
Next
Last

Search