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Article: Clinical Review: Thyrotoxic periodic paralysis: A diagnostic challenge

TitleClinical Review: Thyrotoxic periodic paralysis: A diagnostic challenge
Authors
Issue Date2006
PublisherThe Endocrine Society. The Journal's web site is located at http://jcem.endojournals.org
Citation
Journal Of Clinical Endocrinology And Metabolism, 2006, v. 91 n. 7, p. 2490-2495 How to Cite?
AbstractContext: The aim of this article was to review the clinical presentation, pathogenesis, and management of thyrotoxic periodic paralysis (TPP). Evidence Acquisition: A MEDLINE search was conducted for articles published during the last 40 yr based on the key words thyrotoxic periodic paralysis and hypokalemic periodic paralysis. A total of 281 primary articles and 168 references of the retrieved articles were also reviewed. Evidence Synthesis: TPP is a common complication of hyperthyroidism in Asian men but is increasingly seen in Western countries. Hypokalemia and muscle paralysis results from a sudden intracellular shift of potassium and is not due to potassium deficiency. Clinical features of hyperthyroidism in patients with TPP may be subtle. Immediate potassium supplementation prevents serious cardiopulmonary complications and may hasten the recovery of muscle weakness. Nonselective β-adrenergic blockers can ameliorate and prevent recurrence of the paralytic attacks. This episodic paralysis will remit with definitive control of hyperthyroidism. Increased sodium-potassium ATPase pump activity and enhanced insulin response in patients with TPP is postulated to contribute to the hypokalemia. The genetic predisposition for TPP is not entirely clear. Association of polymorphisms of the calcium channel α1-subunit gene with TPP has been noted. Conclusions: Due to population mobility, TPP is increasingly common in Western countries. Early diagnosis and prompt treatment prevent life-threatening complications associated with hypokalemia and muscle weakness. Assaying of thyroid function in patients with hypokalemic paralysis distinguishes TPP from other forms of hypokalemic periodic paralysis. Copyright © 2006 by The Endocrine Society.
Persistent Identifierhttp://hdl.handle.net/10722/77119
ISSN
2015 Impact Factor: 5.531
2015 SCImago Journal Rankings: 2.940
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKung, AWCen_HK
dc.date.accessioned2010-09-06T07:28:28Z-
dc.date.available2010-09-06T07:28:28Z-
dc.date.issued2006en_HK
dc.identifier.citationJournal Of Clinical Endocrinology And Metabolism, 2006, v. 91 n. 7, p. 2490-2495en_HK
dc.identifier.issn0021-972Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/77119-
dc.description.abstractContext: The aim of this article was to review the clinical presentation, pathogenesis, and management of thyrotoxic periodic paralysis (TPP). Evidence Acquisition: A MEDLINE search was conducted for articles published during the last 40 yr based on the key words thyrotoxic periodic paralysis and hypokalemic periodic paralysis. A total of 281 primary articles and 168 references of the retrieved articles were also reviewed. Evidence Synthesis: TPP is a common complication of hyperthyroidism in Asian men but is increasingly seen in Western countries. Hypokalemia and muscle paralysis results from a sudden intracellular shift of potassium and is not due to potassium deficiency. Clinical features of hyperthyroidism in patients with TPP may be subtle. Immediate potassium supplementation prevents serious cardiopulmonary complications and may hasten the recovery of muscle weakness. Nonselective β-adrenergic blockers can ameliorate and prevent recurrence of the paralytic attacks. This episodic paralysis will remit with definitive control of hyperthyroidism. Increased sodium-potassium ATPase pump activity and enhanced insulin response in patients with TPP is postulated to contribute to the hypokalemia. The genetic predisposition for TPP is not entirely clear. Association of polymorphisms of the calcium channel α1-subunit gene with TPP has been noted. Conclusions: Due to population mobility, TPP is increasingly common in Western countries. Early diagnosis and prompt treatment prevent life-threatening complications associated with hypokalemia and muscle weakness. Assaying of thyroid function in patients with hypokalemic paralysis distinguishes TPP from other forms of hypokalemic periodic paralysis. Copyright © 2006 by The Endocrine Society.en_HK
dc.languageengen_HK
dc.publisherThe Endocrine Society. The Journal's web site is located at http://jcem.endojournals.orgen_HK
dc.relation.ispartofJournal of Clinical Endocrinology and Metabolismen_HK
dc.rightsJournal of Clinical Endocrinology and Metabolism. Copyright © The Endocrine Society.en_HK
dc.subject.meshAntithyroid Agents - therapeutic useen_HK
dc.subject.meshAsiaen_HK
dc.subject.meshElectromyographyen_HK
dc.subject.meshExerciseen_HK
dc.subject.meshGraves Disease - complications - diagnosis - therapyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshHyperthyroidism - complicationsen_HK
dc.subject.meshHypokalemia - complications - drug therapyen_HK
dc.subject.meshHypokalemic Periodic Paralysisen_HK
dc.subject.meshIodine Radioisotopes - therapeutic useen_HK
dc.subject.meshMEDLINEen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMuscle, Skeletal - physiopathologyen_HK
dc.subject.meshMuscular Diseases - diagnosis - etiology - therapyen_HK
dc.subject.meshParalysis - diagnosis - etiology - therapyen_HK
dc.subject.meshPeriodicityen_HK
dc.subject.meshPotassium - metabolismen_HK
dc.subject.meshPotassium Chloride - administration & dosageen_HK
dc.subject.meshSodium-Potassium-Exchanging ATPase - metabolismen_HK
dc.subject.meshThyroid Hormones - physiologyen_HK
dc.subject.meshThyroidectomyen_HK
dc.subject.meshThyrotoxicosis - complications - diagnosis - therapyen_HK
dc.titleClinical Review: Thyrotoxic periodic paralysis: A diagnostic challengeen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0021-972X&volume=91&spage=2490&epage=5&date=2006&atitle=Clinical+review:+Thyrotoxic+periodic+paralysis:+a+diagnostic+challengeen_HK
dc.identifier.emailKung, AWC:awckung@hku.hken_HK
dc.identifier.authorityKung, AWC=rp00368en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1210/jc.2006-0356en_HK
dc.identifier.pmid16608889-
dc.identifier.scopuseid_2-s2.0-33745786609en_HK
dc.identifier.hkuros118432en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33745786609&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume91en_HK
dc.identifier.issue7en_HK
dc.identifier.spage2490en_HK
dc.identifier.epage2495en_HK
dc.identifier.isiWOS:000238840600005-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridKung, AWC=7102322339en_HK

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