Abstract
Hypokalemia can be multifactorial. When the primary driver of hypokalemia is obvious it is easy to miss other contributing causes that could be vital to optimal patient management and outcomes. Our case report highlights the importance of recognizing recurrent, refractory hypokalemia as a diagnostic clue to thyrotoxic periodic paralysis.
Key words: refractory hypokalemia, diagnostic clue, thyrotoxic periodic paralysis, T3 toxicosis, Guillain-Barre syndrome, rhabdomyolysis, acute kidney injury
Introduction: Most cases of thyrotoxic periodic paralysis have been reported in Asian men with the incidence of about 2% in thyrotoxic patients [1]. However, the incidence is reported to be only 0.1 to 0.2% in non-Asian population [2]. A very high degree of clinical suspicion is therefore needed to diagnose thyrotoxic periodic paralysis in non-Asian population. We present a case of thyrotoxic periodic paralysis in a 34y old Caucasian male who presented with clinical features suspicious of Guillain-Barre (GB) syndrome where the finding of severe, recurrent and refractory hypokalemia served as a key diagnostic clue for timely diagnoses and management of thyrotoxic periodic paralysis.