Hypokalemic thyrotoxic periodic paralysis with thyrotoxic psychosis and hypercapnic respiratory failure

Am J Med Sci. 2010 Aug;340(2):147-53. doi: 10.1097/MAJ.0b013e3181cbf567.


Thyrotoxic periodic paralysis is a rare and potentially lethal neuromuscular disease that manifests as recurrent episodic muscle weakness associated with hypokalemia and thyrotoxicosis. Paralysis can rarely involve respiratory muscles leading to acute respiratory failure. The disease primarily affects people of Asian descent, but it is being increasingly reported in other ethnic groups. We review the literature and report a case of hypokalemic thyrotoxic periodic paralysis manifesting as thyroid storm with episodic acute respiratory failure requiring recurrent intubation and eventually requiring thyroidectomy for resolution of symptoms.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Asians
  • Diagnosis, Differential
  • Humans
  • Hypercapnia / etiology
  • Hypercapnia / therapy
  • Hypokalemic Periodic Paralysis / complications*
  • Hypokalemic Periodic Paralysis / diagnosis
  • Male
  • Potassium / administration & dosage
  • Potassium / therapeutic use
  • Psychotic Disorders / etiology*
  • Respiratory Insufficiency / etiology*
  • Respiratory Insufficiency / therapy
  • Thyrotoxicosis / etiology*
  • Thyrotoxicosis / therapy


  • Potassium