Thyrotoxic Periodic Paralysis in an Asian Male With Graves' Disease

Thyrotoxic periodic paralysis (TPP) is a rare but potentially life-threatening complication of hyperthyroidism. We present the case of a 27-year-old Asian male with long-standing, untreated hyperthyroidism who presented with recurrent episodes of sudden, reversible muscle weakness. These episodes involved acute flaccid paralysis predominantly affecting the lower limbs and hypokalemia, which improved rapidly with careful potassium replacement. Further investigation confirmed a diffuse toxic goiter consistent with Graves' disease. Interestingly, anti-acetylcholine receptor antibodies were found in the absence of any clinical findings of myasthenia gravis, suggesting a possible autoimmune predisposition. This case underscores the importance of early recognition of TPP to ensure timely management, prevent recurrence, and reduce the risk of complications.

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Publication Details

Journal
Cureus
Published
2025-11-04
DOI
https://doi.org/10.7759/cureus.96063
Primary Topic
Ion channel regulation and function
Type
article
Field-Weighted Citation Impact
0.00
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article

Thyrotoxic Periodic Paralysis in an Asian Male With Graves' Disease

Muhammad Masudul Hasan Nuri, Ans Ahmad, Basimah Mehmood Wardah
Cureus
Ion channel regulation and function
article

Thyrotoxic Periodic Paralysis in an Asian Male With Graves' Disease

Muhammad Masudul Hasan Nuri, Ans Ahmad, Basimah Mehmood Wardah
article en

Abstract

Thyrotoxic periodic paralysis (TPP) is a rare but potentially life-threatening complication of hyperthyroidism. We present the case of a 27-year-old Asian male with long-standing, untreated hyperthyroidism who presented with recurrent episodes of sudden, reversible muscle weakness. These episodes involved acute flaccid paralysis predominantly affecting the lower limbs and hypokalemia, which improved rapidly with careful potassium replacement. Further investigation confirmed a diffuse toxic goiter consistent with Graves' disease. Interestingly, anti-acetylcholine receptor antibodies were found in the absence of any clinical findings of myasthenia gravis, suggesting a possible autoimmune predisposition. This case underscores the importance of early recognition of TPP to ensure timely management, prevent recurrence, and reduce the risk of complications.

CureusVol. 17(11)
Tabba Heart Institute (PK)
Openalex Percentile: Top 71%
Ion channel regulation and function
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