Ana M Rivas1, Subhanudh Thavaraputta2, Menfil Andres Orellana-Barrios3, John Drew Payne2, David Sotello4, Myrian Vinan-Vega2, Joaquin Lado-Abeal1. 1. From: 1 Department of Internal Medicine, Division of Endocrinology, Texas Tech University Health Science Center, Lubbock, Texas. 2. 2Department of Internal Medicine, Texas Tech University Health Science Center, Lubbock, Texas. 3. 3 Department of Internal Medicine, Division of Cardiology, Texas Tech University Health Science Center, Lubbock, Texas. 4. 4 Department of Internal Medicine, Division of Pulmonology, Texas Tech University Health Science Center, Lubbock, Texas.
Abstract
Thyrotoxic periodic paralysis (TPP) is a muscular disorder characterized by sudden episodes of muscle weakness and hypokalemia in the setting of thyrotoxicosis. OBJECTIVE: We aimed to report our experience with TPP in West Texas and compare its clinical presentation to that of patients admitted for complicated thyrotoxicosis. METHOD: Retrospective review of records of adult patients with admission diagnosis of hyperthyroidism, thyrotoxicosis and/or discharge diagnosis of periodic paralysis seen at our institution in a six-year period. RESULTS: Patients admitted for complicated thyrotoxicosis were more commonly females of a mean age of 44 years. Patients with TPP were more commonly Hispanic males of a mean age of 27 years. Despite no significantly different thyroid hormone levels, patients with TPP presented with less severe signs and symptoms of hyperthyroidism, as reflected by lower Burch Wartofsky score on admission (19 vs 35, p <0.001) and lower occurrence of atrial fibrillation in the TPP group (0% vs 36%, p<0.001). Finally 89% of TPP patients presented with QTc prolongation whereas only 19% of thyrotoxic patient presented with a prolonged QTc. CONCLUSION: Hispanic patients with TTP seems to have relative resistance to the actions of thyroid hormones, and commonly present with QTc prolongation, a risk factor for cardiac arrhythmias.
Thyrotoxic periodic paralysis (TPP) is a muscular disorder characterized by sudden episodes of muscle weakness and hypokalemia in the setting of thyrotoxicosis. OBJECTIVE: We aimed to report our experience with TPP in West Texas and compare its clinical presentation to that of patients admitted for complicated thyrotoxicosis. METHOD: Retrospective review of records of adult patients with admission diagnosis of hyperthyroidism, thyrotoxicosis and/or discharge diagnosis of periodic paralysis seen at our institution in a six-year period. RESULTS:Patients admitted for complicated thyrotoxicosis were more commonly females of a mean age of 44 years. Patients with TPP were more commonly Hispanic males of a mean age of 27 years. Despite no significantly different thyroid hormone levels, patients with TPP presented with less severe signs and symptoms of hyperthyroidism, as reflected by lower Burch Wartofsky score on admission (19 vs 35, p <0.001) and lower occurrence of atrial fibrillation in the TPP group (0% vs 36%, p<0.001). Finally 89% of TPPpatients presented with QTc prolongation whereas only 19% of thyrotoxic patient presented with a prolonged QTc. CONCLUSION: Hispanic patients with TTP seems to have relative resistance to the actions of thyroid hormones, and commonly present with QTc prolongation, a risk factor for cardiac arrhythmias.