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• W3190683417 abstract "Thyrotoxic periodic paralysis (TTP) belongs to the family of diseases called channelopathies, and is manifested by episodes of painless muscle weakness. TPP is an uncommon complication of hyperthyroidism that most often affects young East Asian males, but is increasingly being seen in other ethnic groups. The characteristic presentation is an acute attack, which may present as a spectrum of disease, showing mild weakness to total paralysis. The onset primarily is at night or in the early morning, a few hours either after fasting, a high-carbohydrate meal, a heavy meal, alcohol abuse, or strenuous exercise. It is usually followed by complete recovery within 72 hours. Manifestations of hyperthyroidism may not be obvious. This diagnosis should be contemplated when this demographic of patient presents with marked painless weakness after provocation with exercise or changes in diet. The distinctive indicator is hypokalemia, which develops from increased cellular sodium/potassium-ATPase pump activity with the transport of potassium from the extracellular to the intracellular space in combination with a reduced potassium output. KCNJ18 gene mutations, which alter the function of an inwardly rectifying potassium channel named Kir2.6, have been observed in 0 to 33% of cases. However, two-thirds of TPP patients do not present with mutations in KCNJ18, drawing attention for the need to search other genetic susceptibility mechanisms. Hence, the presentation of TPP includes thyrotoxicosis, a genetic predisposition, along with dietary factors and/or exercise. The relative impact of each of these hereditary and other factors may vary. The initial treatment regimen, which is potassium supplementation, should be given with care, due to a high risk of hyperkalemia. Propranolol is an alternative first-line therapeutic option based on the assumption that hyperadrenergic activity is involved in the pathogenesis. If thyroid function tests are unobtainable in the acute situation, the diagnosis may be supported by the findings of hypokalemia, low spot urine potassium excretion, hypophosphatemia with hypophosphaturia, high spot urine calcium/phosphate ratio, and electrocardiographic abnormalities such as tachycardia, atrial fibrillation, high QRS voltage, and atrioventricular block. The definitive treatment is cure of the hyperthyroidism. The underlying mechanisms of TPP remain incompletely understood and the true etiology and mechanisms of the disease await further studies" @default.
• W3190683417 created "2021-08-16" @default.
• W3190683417 creator A5011120054 @default.
• W3190683417 creator A5047082584 @default.
• W3190683417 creator A5061952775 @default.
• W3190683417 creator A5079304445 @default.
• W3190683417 date "2022-01-01" @default.
• W3190683417 modified "2023-10-17" @default.
• W3190683417 title "Thyrotoxic Periodic Paralysis: A Review and Suggestions for Treatment" @default.
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