Thyrotoxic periodic paralysis

Thyrotoxic periodic paralysis
Location of the thyroid gland in the neck
Thyrotoxic periodic paralysis occurs when the thyroid gland releases excessive amounts of thyroxine (thyroid hormone).
SpecialtyEndocrinology

Thyrotoxic periodic paralysis (TPP) is a rare condition featuring attacks of muscle weakness in the presence of hyperthyroidism (overactivity of the thyroid gland). Hypokalemia (a decreased potassium level in the blood) is usually present during attacks. The condition may be life-threatening if weakness of the breathing muscles leads to respiratory failure, or if the low potassium levels lead to abnormal heart rhythms.[1][2] If untreated, it is typically recurrent in nature.[1]

The condition has been linked with genetic mutations in genes that code for certain ion channels that transport electrolytes (sodium and potassium) across cell membranes. The main ones are the L-type calcium channel α1-subunit[1] and potassium inward rectifier 2.6;[3] it is therefore classified as a channelopathy.[3] The abnormality in the channel is thought to lead to shifts of potassium into cells, under conditions of high thyroxine (thyroid hormone) levels, usually with an additional precipitant.

Treatment of the low levels of potassium in the blood, followed by correction of the hyperthyroidism, leads to complete resolution of the attacks. It occurs predominantly in males of Chinese, Japanese, Vietnamese, Filipino, and Korean descent.[1] TPP is one of several conditions that can cause periodic paralysis.[4]

  1. ^ a b c d Cite error: The named reference Kung was invoked but never defined (see the help page).
  2. ^ Cite error: The named reference Pothiwala was invoked but never defined (see the help page).
  3. ^ a b Cite error: The named reference Ryan was invoked but never defined (see the help page).
  4. ^ Fontaine B (2008). Chapter 1 Periodic Paralysis. Advances in Genetics. Vol. 63. pp. 3–23. doi:10.1016/S0065-2660(08)01001-8. ISBN 978-0-12-374527-9. PMID 19185183.