Abstract
Hipokalemik periyodik paralizi (HPP), ağır egzersiz, diyet yapma veya yüksek karbonhidratlı yemekler ile tetiklenen ve ağrısız kas güçsüzlüğü ataklarıyla karakterize kaslarda iyon kanallarındaki bir defekt ile ilgili olan nadir görülen bir nöromüsküler bozukluktur. Biz bu olguda ani başlangıçlı güç kaybı şikayetiyle Acil Servis (AS)’e başvuran ve daha öncede benzer şikayetleri olan 37 yaşındaki bir erkek hastayı sunuyoruz. AS’te çalışılan rutin kan testlerinde serum potasyum seviyesi belirgin olarak düşük saptandı. Hipokaleminin diğer nedenleri dışlandı. Hastanın semptomları potasyum yerine koyma tedavisi ile 4 saat gibi kısa bir sürede tamamen düzeldi. Bu olgu, ani flask paralizisi ile başvuran genç hastalarda ayırıcı tanıda nadir olmasına rağmen HPP’nin düşünülmesi gerektiğini ve serum potasyum seviyelerine bakılarak kolayca belirlenebileceğini göstermektedir.
Keywords
References
- Stapleton LJ. Hypokalaemia periodic paralysis. ScottMed J. 2018; 63(1):28-31.
- Fontaine B. Periodic paralysis. Adv Genet. 2008; 63: 3–23.
- Sardar Z, Waheed KAF, Javed MA, Akhtar F, Bokhari SRA. Clinical and Etiological Spectrum of Hypokalemic Periodic Paralysis in a Tertiary Care Hospital in Pakistan. Cureus. 2019; 11(1):e3921. doi: 10.7759/cureus.3921.
- Statland JM, Fontaine B, Hanna MG, Johnson NE, Kissel JT, Sansone VA, et al. Review of the Diagnosis and Treatment of Periodic Paralysis. Muscle Nerve. 2018;57(4):522-530.
- Wang XY, Ren BW, Yong ZH, Xu HY, Fu QX, Yao HB. Mutation analysis of CACNA1S and SCN4A in patients with hypokalemic periodic paralysis. Mol Med Rep. 2015;12(4):6267-74.
- Lin SH. Thyrotoxic periodic paralysis. Mayo Clin Proc. 2005; 80:99-105
- Miller TM, Dias da Silva MR, Miller HA, et al. Correlating phenotype and genotype in the periodic paralyses. Neurology. 2004;63(9):1647-1655.
- Sansone V, Statland JM, Fontaine B, Hanna MG, Johnson NE, Kissel JT, Sansone VA. Review of the Diagnosis and Treatment of Periodic Paralysis. Muscle Nerve. 2018;57(4):522-530.
- Alkaabi JM, Mushtaq A, Al-Maskari FN, Moussa NA, Gariballa S. Hypokalemic periodic paralysis: a case series, review of the literatüre and update of management. Eur J Emerg Med. 2010;17(1):45-47.
- Schell E, Pathman J, Pescatore R, Bianchi PW. A case of thiazide-induced hypokalemic paralysis. Clin Pract Cases Emerg Med. 2019;3(3):211-214.
Abstract
Hypokalemic periodic paralysis (HPP) is a rare neuromuscular disorder that is triggered by heavy exercise, dieting, or high-carb meals, and is associated with a defect in the ion channels in muscles characterized by painless attacks of muscle weakness. We report a case of a 37-year-old man who presented Emergency Department (ED) with sudden onset paralysis and had similar complaints before. The serum potassium level of the patient was significantly low in emergency routine blood tests. Other causes of hypokalaemia were excluded. The patient's symptoms improved completely in as little as 4 hours with potassium replacement therapy. This case demonstrates that, although rare, HPP should be considered as a differential diagnosis in young patients who present with sudden flaccid paralysis and can easily be determined by checking serum potassium levels at presentation.
References
- Stapleton LJ. Hypokalaemia periodic paralysis. ScottMed J. 2018; 63(1):28-31.
- Fontaine B. Periodic paralysis. Adv Genet. 2008; 63: 3–23.
- Sardar Z, Waheed KAF, Javed MA, Akhtar F, Bokhari SRA. Clinical and Etiological Spectrum of Hypokalemic Periodic Paralysis in a Tertiary Care Hospital in Pakistan. Cureus. 2019; 11(1):e3921. doi: 10.7759/cureus.3921.
- Statland JM, Fontaine B, Hanna MG, Johnson NE, Kissel JT, Sansone VA, et al. Review of the Diagnosis and Treatment of Periodic Paralysis. Muscle Nerve. 2018;57(4):522-530.
- Wang XY, Ren BW, Yong ZH, Xu HY, Fu QX, Yao HB. Mutation analysis of CACNA1S and SCN4A in patients with hypokalemic periodic paralysis. Mol Med Rep. 2015;12(4):6267-74.
- Lin SH. Thyrotoxic periodic paralysis. Mayo Clin Proc. 2005; 80:99-105
- Miller TM, Dias da Silva MR, Miller HA, et al. Correlating phenotype and genotype in the periodic paralyses. Neurology. 2004;63(9):1647-1655.
- Sansone V, Statland JM, Fontaine B, Hanna MG, Johnson NE, Kissel JT, Sansone VA. Review of the Diagnosis and Treatment of Periodic Paralysis. Muscle Nerve. 2018;57(4):522-530.
- Alkaabi JM, Mushtaq A, Al-Maskari FN, Moussa NA, Gariballa S. Hypokalemic periodic paralysis: a case series, review of the literatüre and update of management. Eur J Emerg Med. 2010;17(1):45-47.
- Schell E, Pathman J, Pescatore R, Bianchi PW. A case of thiazide-induced hypokalemic paralysis. Clin Pract Cases Emerg Med. 2019;3(3):211-214.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Emergency Medicine |
| Journal Section | Case Report |
| Authors | |
| Publication Date | June 5, 2020 |
| Submission Date | September 27, 2019 |
| Acceptance Date | April 24, 2020 |
| Published in Issue | Year 2020 Volume: 6 Issue: 2 |
