Thyrotoxic periodic paralysis in a white woman

A 24 year old white woman presented with sudden onset of flaccid quadriparesis and hypokalaemia. She was later found to be thyrotoxic. Paralysis resolved with potassium supplements, and after initiation of antithyroid medication she had no further episodes of hypokalaemic paralysis. To the best of the authors' knowledge, and after a Medline search, thyrotoxic periodic paralysis has not been described previously in a white woman.     

Thyrotoxic periodic paralysis in a Polynesian male following highly active antiretroviral therapy for HIV infection

Hyperthyroidism has been described after highly active antiretroviral therapy for AIDS and has been attributed to late onset immune reconstitution. The team reports a young Polynesian man with AIDS who responded to highly active antiretroviraltherapy. However, 15 months after initiation of antiretroviral therapy, he was hospitalized for hypokalemic thyrotoxic periodic paralysis, an unusual manifestation of hyperthyroidism which typically occurs in young Asian males.     

低钾性周期性麻痹84例临床分析

目的:总结低钾性周期性麻痹(hypoKPP)的临床表现和疗效,探讨其发病机制及预防措施。方法:回顾分析84例确诊的低钾性周期性麻痹患者的临床资料。结果:84例患者中,原发性60例,其中有家族史者5例,散发54例;继发性24例,其中继发于甲亢者19例。有心电图资料者62例,其中,正常10例,有典型低血钾改变者52例。伴有四肢麻木者6例,肌肉酸痛者5例。经过口服和静脉注射钾后,全部病例均获得痊愈。结论:血清钾及心电图的检查有利于早期诊断及治疗。继发性者要加强原发病治疗,避免各种诱因是防止复发的关键。     

低钾性周期性麻痹84例临床分析

目的：总结低钾性周期性麻痹（hypoKPP）的临床表现和疗效，探讨其发病机制及预防措施。方法：回顾分析84例确诊的低钾性周期性麻痹患者的临床资料。结果：84例患者中，原发性60例，其中有家族史者5例，散发54例；继发性24例，其中继发于甲亢者19例。有心电图资料者62例，其中，正常10例，有典型低血钾改变者52例。伴有四肢麻木者6例，肌肉酸痛者5例。经过口服和静脉注射钾后，全部病例均获得痊愈。结论：血清钾及心电图的检查有利于早期诊断及治疗。继发性者要加强原发病治疗，避免各种诱因是防止复发的关键。     

Thyrotoxicosis, myasthenia gravis and periodic paralysis in a Chinese man

The association of myasthenia gravis and periodic paralysis in thyrotoxicosis has not been reported before. We describe a Chinese man with thyrotoxicosis and myasthenia gravis, who subsequently developed periodic paralysis. The possible aetiological links are discussed.     

Increased frequency of HLA-DR3 in Mexican mestizo pediatric patients with amebic liver abscess (ALA).

Mexican mestizo pediatric patients with ALA revealed a significantly increased frequency of HLA-DR3 alone, or in its haplotype form HLA-A2, DR3, which confirms our previous observation in adult patients with ALA in the same ethnic group. However, the relative increase in these HLA specificities in pediatric ALA patients when compared to adult patients was not statistically significant, and calls for an enlargement of the population studied.     

甲状腺功能亢进合并低钾血症及周期性麻痹的临床研究

回顾分析1225例甲状腺功能亢进症（甲亢）患者临床资料,了解低钾血症和周期性麻痹的发生情况.其中单纯低钾血症者104例（8.5%）,女性占82.7%（86/104）,血钾为3.10～3.42mmol/L;周期性麻痹者60例（4.9%）,男性占96.7%（58/60）,血钾低于3.0 mmol/L者占93.3%（56/60）.甲亢控制后低钾血症和周期性麻痹均可缓解.     

Hypokalaemic periodic paralysis in a thyrotoxic Polynesian.

Hypokalaemic periodic paralysis in a thyrotoxic Polynesian is described. The possible pathophysiology is discussed. Though common in Orientals, this condition is uncommon in Caucasians and has not been described before in a Polynesian.     

Hyperkalaemic periodic paralysis: a rare presentation of Addison's disease

A 44 year old man with longstanding diabetes mellitus gave a 6-month history of periodic attacks of flaccid quadriplegia. Following one of these episodes he was admitted for assessment. In view of persistent hyperkalaemia, hypoadrenalism was suspected and Addison's disease was confirmed biochemically. Adrenal replacement therapy restored the potassium levels to normal and resulted in no further attacks of paralysis.     

Hyperthyroidism with gynaecomastia, galactorrhoea and periodic paralysis.

A 32 year old male thyrotoxic presenting with gynaecomastia, galactorrhoea and later complicated with hypokalaemic periodic paralysis is presented. The gynaecomastia and galactorrhoea resolved with treatment. To the best of the author's knowledge this combination of association in one patient has not been reported previously.     

低钾性周期性麻痹64例病因分析

目的:探讨低钾性周期性麻痹的病因.方法:对64例低钾性周期性麻痹患者进行了血清K 、Na 、Cl-、CO2-CP、心电图、尿常规、甲状腺功能检查,部分进行了血清醛固酮检测,腹部CT、MRI及氯化铵负荷试验.结果:43例最终确诊为原发性低钾性周期性麻痹;16例为甲亢伴低钾性麻痹;1例为肾小管酸中毒伴低钾性麻痹;2例为醛固酮增多症伴低钾性麻痹;2例为药物所致低钾性麻痹.结论:低钾性周期性麻痹分为原发性及继发性两种.原发性低钾性周期性麻痹为常染色体显性遗传病;继发性低钾性周期性麻痹以甲状腺功能亢进症伴低钾性麻痹、肾小管酸中毒、原醛为其常见病因.     

Thyrotoxic hypokalaemic paralysis in a pregnant Afro-Caribbean woman. A case report and review of the literature

This paper reports the case of a 21-year-old Afro-Caribbean pregnant woman with hyperthyroidism and hypokalaemic quadriparesis and reviews the literature on the topic. Thyrotoxic periodic paralysis is a very rare condition in the Caribbean. This case reminds West Indian physicians to consider this rare condition in any patient that presents with paralysis.     

Factors affecting resolution of pericardial effusions in primary hypothyroidism: a clinical, biochemical and echocardiographic study

Echocardiography detected pericardial effusions in five out of six consecutive untreated patients with severe primary hypothyroidism and suspected myopathy, whereas the chest X-ray suggested only one. During L-thyroxine replacement, serial echocardiograms detected decrease in the size of the effusions in all the patients. This occurred before the serum thyroid stimulating hormone (TSH) levels had significantly changed, although there was a small but significant rise in serum thyroxine. In one patient complete resolution of the effusion occurred before the patient became euthyroid, a previously unreported finding.     

合并低钾型周期性麻痹的手术患者基因突变筛查及麻醉处理

目的 通过筛查原发性低钾型周期性麻痹(hypokalaemic periodic paralysis,HOKPP)相关基因突变位点,探讨合并HOKPP患者的手术麻醉处理方法 .总结该类患者麻醉处理注意事项.方法 应用PCR-直接测序技术.对5例HOKPP患者进行候选基因CACNAlS和SCN4A筛查.并对该5例患者在静脉复合气管插管全麻下,分别施行上腹部手术、声带息肉摘除术及鼻息肉摘除术,麻醉诱导用眯达唑仑0.1mg/kg.丙泊酚2mg/kg,芬太尼4 μg/kg,罗库澳铵0.6mg/kg.麻醉维持间断静注芬太尼、罗库溴铵,持续微泵静注丙泊酚.结果 DNA测序结果 发现1例患者的CACNA1S基因外显子30上存在3716(G→A)杂合突变.导致氨基酸序列R1239H改变.该组HOKPP患者在围手术期生命体征稳定,手术过程顺利.未出现血电解质紊乱、心律失常、HOKPP发作、恶性高热等麻醉意外和并发症.术毕至气管拔管的时间为40～90min.结论 HOKPP存在CACNA1S基因突变,在手术过程中应注意HOKPP患者的血钾浓度变化,心电图监测,避免心律失常发生,同时注意麻醉方式和麻醉药物的选择,避免麻醉药物选择不当诱发HOKPP、恶性高热等麻醉意外和严重并发症.