ACUTE HYPOKALEMIC PARALYSIS AND HASHIMOTO’S THYROIDITIS

Authors

  • Rafiq Ullah Khyber Teaching Hospital Peshawar
  • Awais Naeem Khyber Teaching Hospital
  • Fahad Naim Khyber Teaching Hospital
  • Qasim Zia Khyber Teaching Hospital
  • Omama Hamayun Khyber Teaching Hospital

DOI:

https://doi.org/10.55519/JAMC-04-10918

Keywords:

Acute hypokalemic paralysis, , Distral renal tubular acidosis, , paralysis, dRTA, Hypothyroidism

Abstract

Acute hypokalemic paralysis (AHP) is a life-threatening emergency. It is exceptionally unusual for hypothyroidism to present with AHP. This association can be either primary or secondary through distal renal tubular acidosis. We report two cases who presented with acute quadriplegia. The succeeding investigations revealed severe hypokalemia and autoimmune hypothyroidism. The second case was found to have Sjogren’s syndrome additionally. The underlying etiology of hypokalemia in both cases was found to be dRTA. The combination of such conditions is reported sporadically. Here we also discuss the potential association of AHP with autoimmune conditions by proxy through dRTA.

Author Biographies

Rafiq Ullah, Khyber Teaching Hospital Peshawar

Trainee Medical Officer in Medical "A" Unit

Awais Naeem, Khyber Teaching Hospital

Assistant Professor in Medical "A" Unit Chairman of Medicine Department, MTI Khyber Teaching Hospital Peshawar

Fahad Naim, Khyber Teaching Hospital

Assistant Professor in Medical "A" Unit of MTI Khyber Teaching Hospital

Qasim Zia, Khyber Teaching Hospital

Medical Registrar in Medical "A" Unit of MTI Khyber Teaching Hospital

Omama Hamayun, Khyber Teaching Hospital

Trainee Medical Officer in Medical "A" Unit of MTI Khyber Teaching Hospital

References

Velarde-Mejía Y, Gamboa-Cárdenas R, Ugarte-Gil M, Asurza CP. Hypokalemic Paralysis: A Hidden Card of Several Autoimmune Diseases. Clin Med Insights Arthritis Musculoskelet Disord 2017;10:1179544117722763.

Arambewela MH, Sumanathilaka MR, Pathirana KD, Bodinayaka CK. A possible association of hypokalaemic periodic paralysis, autoimmune thyroiditis and neuromyotonia. Ceylon Med J 2013;58(4):175–6.

Bandhakavi M. Periodic paralysis as an unusual presentation of autoimmune hypothyroidism with goiter. Clin Pediatr (Phila) 2009;48(6):677–8.

Sinha U, Sengupta N, Sinharay K, Sahana PK. Recurrent hypokalemic paralysis: An atypical presentation of hypothyroidism. Indian J Endocrinol Metab 2013;17(1):174–6.

Meregildo-Rodríguez ED, Failoc-Rojas VE. Case Report: Recurrent hypokalemic periodic paralysis associated with distal renal tubular acidosis (type 1) and hypothyroidism secondary to Hashimoto's thyroiditis. F1000Res 2018;7:1154.

Koul PA, Wahid A. Distal renal tubular acidosis and hypokalemic paralysis in a patient with hypothyroidism. Saudi J Kidney Dis Transpl 2011;22(5):1014–6.

Lim S. Approach to hypokalemia. Acta Med Indones 2007;39(1):56–64.

Mustaqeem R, Arif A. Renal Tubular Acidosis. In: StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2021, StatPearls Publishing LLC.; 2021.

Sedhain A, Acharya K, Sharma A, Khan A, Adhikari S. Renal Tubular Acidosis and Hypokalemic Paralysis as a First Presentation of Primary Sjögren's Syndrome. Case Rep Nephrol 2018;2018:9847826.

Kadeeja N, Senthilnathan N, Viswanathan S, Aghoram R. Sporadic hypothyroidism-related hypokalemic paralysis: Diagnosis in a resource-poor setting. J Family Med Prim Care 2017;6(4):862–4.

Yılmaz H, Kaya M, Özbek M, ÜUreten K, Safa Yıldırım İ. Hypokalemic periodic paralysis in Sjogren's syndrome secondary to distal renal tubular acidosis. Rheumatol Int 2013;33(7):1879–82.

Inagaki K, Otsuka F, Otani H, Sato C, Miyoshi T, Ogura T, et al. Apparent mineralocorticoid excess manifested in an elderly patient with hypothyroidism. Am J Hypertens 2007;20(1):104–7.

Talal N, Zisman E, Schur PH. Renal tubular acidosis, glomerulonephritis and immunologic factors in Sjögren's syndrome. Arthritis Rheum 1968;11(6):774–86.

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Published

2022-09-28