{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T11:10:09Z","timestamp":1756293009046,"version":"3.44.0"},"reference-count":7,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T00:00:00Z","timestamp":1624406400000},"content-version":"unspecified","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,6,6]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>Hypokalaemic periodic paralysis secondary to subclinical hyperthyroidism is an uncommon clinical phenomenon characterised by lower limb paralysis secondary to hypokalaemia in the background of subclinical hyperthyroidism. In this article, we report a patient who presented with progressive lower limb muscle weakness secondary to hypokalaemia that was refractory to potassium replacement therapy. He has no diarrhoea, no reduced appetite and was not taking any medication that can cause potassium wasting. Although he was clinically euthyroid, his thyroid function test revealed subclinical hyperthyroidism. His 24-hour urine potassium level was normal, which makes a rapid transcellular shift of potassium secondary to subclinical hyperthyroidism as the possible cause. He was successfully treated with potassium supplements, non-selective beta-blockers and anti-thyroid medication. This case report aimed to share an uncommon case of hypokalaemic periodic paralysis secondary to subclinical hyperthyroidism, which to our knowledge, only a few has been reported in the literature.<\/jats:p>","DOI":"10.1136\/bcr-2020-240666","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T12:20:40Z","timestamp":1624537240000},"page":"e240666","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Hypokalaemic periodic paralysis secondary to subclinical hyperthyroidism: an uncommon cause of acute muscle paralysis"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4675-103X","authenticated-orcid":false,"given":"Alvin Oliver","family":"Payus","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia"},{"name":"Department of Internal Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sat Lin","family":"Liew","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nee","family":"Tiong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norlaila","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,6,24]]},"reference":[{"key":"2025082703321456000_14.6.e240666.1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/649502","article-title":"Thyrotoxic periodic paralysis: clinical challenges","volume":"2014","author":"Vijayakumar","year":"2014","journal-title":"J Thyroid Res"},{"unstructured":"Kasper D , Fauci A , Hauser S . Harrison\u2019s principles of internal medicine. 19 edn. Mcgraw-hill, 2015.","key":"2025082703321456000_14.6.e240666.2"},{"key":"2025082703321456000_14.6.e240666.3","doi-asserted-by":"crossref","first-page":"18","DOI":"10.5049\/EBP.2012.10.1.18","article-title":"Etiology of hypokalemic paralysis in Korea: data from a single center","volume":"10","author":"Wi","year":"2012","journal-title":"Electrolyte Blood Press"},{"doi-asserted-by":"publisher","key":"2025082703321456000_14.6.e240666.4","DOI":"10.4103\/0972-2327.99708"},{"key":"2025082703321456000_14.6.e240666.5","first-page":"OD14","article-title":"Hypokalaemic periodic paralysis in a patient with subclinical hyperthyroidism: a rare case","volume":"10","author":"Hegde","year":"2016","journal-title":"J Clin Diagn Res"},{"key":"2025082703321456000_14.6.e240666.6","first-page":"e73","article-title":"Hypokalemic periodic paralysis in a patient with euthyroid Graves disease and celiac disease","volume":"5","author":"Rajpal","year":"2019","journal-title":"AACE Clin Case Rep"},{"key":"2025082703321456000_14.6.e240666.7","doi-asserted-by":"crossref","DOI":"10.4103\/ijmr.IJMR_335_18","article-title":"Thyrotoxic periodic paralysis: a retrospective, observational study from India","volume":"151","author":"Verma","year":"2020","journal-title":"Indian J Med Res"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-240666","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:32:22Z","timestamp":1756290742000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-240666"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":7,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,24]]},"published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1136\/bcr-2020-240666"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-240666","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,6]]}}}