TY - JOUR
T1 - Chronic Alcohol Abuse-Induced Hypokalemia Might Lead to Delayed Diagnosis or Misdiagnosis of Thyrotoxic Periodic Paralysis
AU - Lin, Yan-Yu
AU - Hsieh, Yu-Shan
N1 - Copyright © 2021, Lin et al.
PY - 2021/6
Y1 - 2021/6
N2 - Thyrotoxic periodic paralysis is an uncommon and potentially life-threatening complication of thyrotoxicosis and hyperthyroidism characterized by acute and reversible episodes of muscle weakness and hypokalemia. Here is a 41-year-old Taiwanese male patient without any family history of hyperthyroidism presented to the emergency room of our institution with initial symptom of acute lower limb weakness. Laboratory analysis revealed uncommonly severe hypokalemia (<1.5 mEq/L). A thyroid function test revealed hyperthyroidism, and thyroid ultrasonography revealed findings compatible with Graves' disease. However, symptoms such as nausea, vomiting, diarrhea, and heavy breathing were absent. He was administered with 15 mg of methimazole and 30 mg of propranolol per day for complications of hyperthyroidism. Then we exhaustively evaluated the patient's history and lifestyle habits, and found that the patient had chronic alcohol abuse (an 1-L bottle 45%-48% liquor per week) for more than 10 years. In this case, chronic alcohol abuse may have increased the patient's tolerance to the profound hypokalemia such that it did not immediately show critical symptoms. Therefore, according to this case report, we suggest that chronic alcohol consumption or abuse may lead patients, especially those with hyperthyroidism, to ignore or delay treatment.
AB - Thyrotoxic periodic paralysis is an uncommon and potentially life-threatening complication of thyrotoxicosis and hyperthyroidism characterized by acute and reversible episodes of muscle weakness and hypokalemia. Here is a 41-year-old Taiwanese male patient without any family history of hyperthyroidism presented to the emergency room of our institution with initial symptom of acute lower limb weakness. Laboratory analysis revealed uncommonly severe hypokalemia (<1.5 mEq/L). A thyroid function test revealed hyperthyroidism, and thyroid ultrasonography revealed findings compatible with Graves' disease. However, symptoms such as nausea, vomiting, diarrhea, and heavy breathing were absent. He was administered with 15 mg of methimazole and 30 mg of propranolol per day for complications of hyperthyroidism. Then we exhaustively evaluated the patient's history and lifestyle habits, and found that the patient had chronic alcohol abuse (an 1-L bottle 45%-48% liquor per week) for more than 10 years. In this case, chronic alcohol abuse may have increased the patient's tolerance to the profound hypokalemia such that it did not immediately show critical symptoms. Therefore, according to this case report, we suggest that chronic alcohol consumption or abuse may lead patients, especially those with hyperthyroidism, to ignore or delay treatment.
U2 - 10.7759/cureus.15880
DO - 10.7759/cureus.15880
M3 - Article
C2 - 34336407
SN - 2168-8184
VL - 13
SP - e15880
JO - Cureus
JF - Cureus
IS - 6
ER -
SDG 3 良好的健康和福祉