{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T14:16:32Z","timestamp":1776867392819,"version":"3.51.2"},"reference-count":16,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,12,31]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:p>A male patient aged in his early twenties presented to the emergency department (ED) with quadriparesis. He was ordinarily fit and well and had exercised and eaten a carbohydrate rich meal the evening before. His point-of-care venous blood sample on arrival to the ED showed hypokalaemia of 1.6\u2009mmol\/L. (normal range=3.5\u20135.0\u2009mmol\/L). He was put on a cardiac monitor and started on an intravenous infusion of potassium chloride. With the benefit of hindsight, his male sex, particular features in his history and his initial ECG all pointed to a differential diagnosis of thyrotoxic periodic paralysis (TPP), although a differential diagnosis of a first attack of familial hypokalaemic paralysis was considered. As urgent thyroid function tests were sent promptly, there was minimal delay in reaching a diagnosis of TPP and promptly starting propranolol as a safe and more effective means of reversing TPP, followed by definitive treatment with carbimazole.<\/jats:p>","DOI":"10.1136\/bcr-2021-245830","type":"journal-article","created":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T11:34:04Z","timestamp":1645788844000},"page":"e245830","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Thyrotoxic periodic paralysis (TPP): assessment in the emergency department"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0416-3555","authenticated-orcid":false,"given":"Freyia","family":"Mahon-Daly","sequence":"first","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Liegeois","sequence":"additional","affiliation":[{"name":"Emergency Department, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John-Paul","family":"Carter","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,2,25]]},"reference":[{"key":"2025082713083997000_15.2.e245830.1","doi-asserted-by":"crossref","first-page":"2490","DOI":"10.1210\/jc.2006-0356","article-title":"Thyrotoxic periodic paralysis: a diagnostic challenge","volume":"91","author":"Kung","year":"2006","journal-title":"The Journal of Clinical Endocrinology & Metabolism"},{"key":"2025082713083997000_15.2.e245830.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.5538.451"},{"key":"2025082713083997000_15.2.e245830.3","doi-asserted-by":"crossref","first-page":"3879","DOI":"10.1210\/jc.2003-032089","article-title":"The thyroid epidemiology, audit, and research study: thyroid dysfunction in the general population","volume":"89","author":"Flynn","year":"2004","journal-title":"The Journal of Clinical Endocrinology & Metabolism"},{"key":"2025082713083997000_15.2.e245830.4","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1507\/endocrj1954.39.315","article-title":"Comparison of the incidence of association of periodic paralysis and hyperthyroidism in Japan in 1957 and 1991","volume":"39","author":"Shizume","year":"1992","journal-title":"Endocrinol Jpn"},{"key":"2025082713083997000_15.2.e245830.5","first-page":"293","article-title":"Thyrotoxic periodic paralysis in a Caucasian man in treatment for Graves' disease","volume":"42","author":"Didonna","year":"2000","journal-title":"Panminerva Med"},{"key":"2025082713083997000_15.2.e245830.6","unstructured":"Marieb E , Hoehn K . 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