PDF(Pubmed)
Abstract：
Thyrotoxic periodic paralysis (TPP) is an endocrine emergency presenting with acute-onset flaccid paralysis in a patient having thyrotoxicosis accompanied by hypokalaemia. This study was conducted to evaluate the clinical profile of patients with TPP presenting to three centres in India.
This retrospective, observational study was conducted at three tertiary care Armed Forces medical centres, located at Lucknow, Kolkata and Delhi. The history, clinical features, treatment details and outcomes were evaluated.
Of the 244 patients with thyrotoxicosis, 15 were diagnosed with TPP and included in the study. These 15 patients (14 male and 1 female) had 32 episodes of TPP which were analyzed. The mean age was 30.2±6.2 yr (range: 21-39), and overt thyrotoxicosis was seen in all patients except one who had subclinical hyperthyroidism. Graves\' disease was the most common cause of thyrotoxicosis (13/15) and the remaining two patients had subacute thyroiditis and gestational thyrotoxicosis. Hypokalaemia (serum potassium <3.5 mmol/l) was seen in 12 patients, and the mean serum potassium was 3.2±0.9 mmol/l (range: 2.1-4.9). All patients had flaccid weakness, predominantly involving the lower limb with no bulbar, respiratory or cranial nerve involvement. The average duration of paralysis was 10.6±5.7 h (range: 3-28 h).
Our study demonstrated an early age of presentation and presence of clinical and biochemical thyrotoxicosis in majority of patients with TPP. Hypokalaemia may not always be evident in patients with TPP.
This retrospective, observational study was conducted at three tertiary care Armed Forces medical centres, located at Lucknow, Kolkata and Delhi. The history, clinical features, treatment details and outcomes were evaluated.
Of the 244 patients with thyrotoxicosis, 15 were diagnosed with TPP and included in the study. These 15 patients (14 male and 1 female) had 32 episodes of TPP which were analyzed. The mean age was 30.2±6.2 yr (range: 21-39), and overt thyrotoxicosis was seen in all patients except one who had subclinical hyperthyroidism. Graves\' disease was the most common cause of thyrotoxicosis (13/15) and the remaining two patients had subacute thyroiditis and gestational thyrotoxicosis. Hypokalaemia (serum potassium <3.5 mmol/l) was seen in 12 patients, and the mean serum potassium was 3.2±0.9 mmol/l (range: 2.1-4.9). All patients had flaccid weakness, predominantly involving the lower limb with no bulbar, respiratory or cranial nerve involvement. The average duration of paralysis was 10.6±5.7 h (range: 3-28 h).
Our study demonstrated an early age of presentation and presence of clinical and biochemical thyrotoxicosis in majority of patients with TPP. Hypokalaemia may not always be evident in patients with TPP.
摘要：
甲状腺毒性周期性麻痹（TPP）是一种内分泌紧急情况，在甲状腺毒症伴低钾血症的患者中表现为急性发作性弛缓性麻痹。进行这项研究是为了评估印度三个中心的TPP患者的临床状况。
这次回顾展,观察性研究在三个三级保健武装部队医疗中心进行，位于勒克瑙,加尔各答和德里。历史,临床特征,评估了治疗细节和结局.
在244例甲状腺毒症患者中，15例患者被诊断为TPP并纳入研究。这15名患者(14名男性和1名女性)有32次TPP发作,其被分析。平均年龄为30.2±6.2岁（范围：21-39岁），除一名亚临床甲状腺功能亢进患者外，所有患者均出现明显的甲状腺毒症。Graves病是甲状腺毒症的最常见原因（13/15），其余两名患者患有亚急性甲状腺炎和妊娠甲状腺毒症。低钾血症（血清钾<3.5mmol/l）见于12例患者，平均血清钾为3.2±0.9mmol/l（范围：2.1-4.9）。所有病人都有松弛无力,主要累及下肢，没有延髓，呼吸或脑神经受累。平均瘫痪时间为10.6±5.7h（范围：3-28h）。
我们的研究表明，在大多数TPP患者中，临床和生化甲状腺毒症的出现年龄较早。低钾血症在TPP患者中可能并不总是明显的。
这次回顾展,观察性研究在三个三级保健武装部队医疗中心进行，位于勒克瑙,加尔各答和德里。历史,临床特征,评估了治疗细节和结局.
在244例甲状腺毒症患者中，15例患者被诊断为TPP并纳入研究。这15名患者(14名男性和1名女性)有32次TPP发作,其被分析。平均年龄为30.2±6.2岁（范围：21-39岁），除一名亚临床甲状腺功能亢进患者外，所有患者均出现明显的甲状腺毒症。Graves病是甲状腺毒症的最常见原因（13/15），其余两名患者患有亚急性甲状腺炎和妊娠甲状腺毒症。低钾血症（血清钾<3.5mmol/l）见于12例患者，平均血清钾为3.2±0.9mmol/l（范围：2.1-4.9）。所有病人都有松弛无力,主要累及下肢，没有延髓，呼吸或脑神经受累。平均瘫痪时间为10.6±5.7h（范围：3-28h）。
我们的研究表明，在大多数TPP患者中，临床和生化甲状腺毒症的出现年龄较早。低钾血症在TPP患者中可能并不总是明显的。
