Atrial Arrhythmia: A Rare Presentation of Thyrotoxic Hypokalemic Periodic Paralysis

Thyrotoxic hypokalemic periodic paralysis is a rare but life-threatening complication of hyperthyroidism characterized by hyperthyroidism, hypokalemia, and transient episodes of acute proximal muscle weakness. Incidence of thyrotoxic hypokalemic periodic paralysis is more common in Asian men and extremely rare in blacks. The basic mechanism includes thyrotoxicosis-induced hypokalemia leading to muscle weakness associated with respiratory insufficiency and fatal arrhythmias. We present a rare case of atrial arrhythmia as the initial presentation of thyrotoxic hypokalemic periodic paralysis.