{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T16:04:46Z","timestamp":1784217886778,"version":"3.55.0"},"reference-count":16,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,7,4]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>Thyrotoxic periodic paralysis (TPP) is a rare variant presentation associated with thyrotoxicosis. It is characterised by acute hypokalaemic paralysis due to intracellular potassium shift. We describe a man in his early 30s who presented with sudden-onset flaccid quadriparesis and transient self-reverted broad-complex tachycardia. Arterial blood gas analysis revealed severe hypokalaemia (1.2 mmol\/L; reference range 3.5\u20135.1\u2009mmol\/L). Thyroid function tests demonstrated suppressed thyroid-stimulating hormone (&lt;0.01\u2009mIU\/L; reference range 0.4\u20134.0\u2009mIU\/L) with markedly elevated free triiodothyronine and thyroxine levels, consistent with thyrotoxicosis due to Graves\u2019 disease. He was treated with cautious intravenous potassium replacement and initiation of antithyroid therapy with beta-blockade, resulting in rapid and complete neurological recovery. This case underscores the importance of recognising TPP as a distinct clinical presentation of thyrotoxicosis in young men presenting with acute paralysis and cardiac arrhythmia.<\/jats:p>","DOI":"10.1136\/bcr-2025-267568","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T15:20:27Z","timestamp":1784215227000},"page":"e267568","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Thyrotoxic periodic paralysis presenting with transient ventricular arrhythmia: a rare variant presentation of Graves\u2019 disease"],"prefix":"10.1136","volume":"19","author":[{"given":"Prachee","family":"Makashir","sequence":"first","affiliation":[{"name":"General Medicine, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3793-7790","authenticated-orcid":false,"given":"Isha","family":"Gupta","sequence":"additional","affiliation":[{"name":"General Medicine, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuj","family":"Darak","sequence":"additional","affiliation":[{"name":"Cardiology, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"2026071608200986000_19.7.e267568.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.5538.451"},{"key":"2026071608200986000_19.7.e267568.2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-0356"},{"key":"2026071608200986000_19.7.e267568.3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.303.6810.1096"},{"key":"2026071608200986000_19.7.e267568.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2009.12.024"},{"key":"2026071608200986000_19.7.e267568.5","doi-asserted-by":"publisher","DOI":"10.1530\/EC-18-0109"},{"key":"2026071608200986000_19.7.e267568.6","doi-asserted-by":"publisher","DOI":"10.4065\/80.1.99"},{"key":"2026071608200986000_19.7.e267568.7","doi-asserted-by":"publisher","DOI":"10.1172\/JCI109244"},{"key":"2026071608200986000_19.7.e267568.8","doi-asserted-by":"crossref","DOI":"10.3390\/biomedicines13081862","article-title":"The Clinical Spectrum of Acquired Hypomagnesemia: From Etiology to Therapeutic Approaches","volume":"13","author":"Floris","year":"2025","journal-title":"Biomedicines"},{"key":"2026071608200986000_19.7.e267568.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2004.09.016"},{"key":"2026071608200986000_19.7.e267568.10","doi-asserted-by":"crossref","DOI":"10.12998\/wjcc.v13.i7.101214","article-title":"Insulin-induced severe thyrotoxic periodic paralysis: A case report","volume":"13","author":"Wang","year":"2025","journal-title":"World J Clin Cases"},{"key":"2026071608200986000_19.7.e267568.11","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.6.601"},{"key":"2026071608200986000_19.7.e267568.12","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199205000-00001"},{"key":"2026071608200986000_19.7.e267568.13","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2001.22090"},{"key":"2026071608200986000_19.7.e267568.14","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/89.6.463"},{"key":"2026071608200986000_19.7.e267568.15","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.116.004667","article-title":"Electrophysiology of Hypokalemia and Hyperkalemia","volume":"10","author":"Weiss","year":"2017","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2026071608200986000_19.7.e267568.16","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(67)90233-5"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-267568","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T15:20:28Z","timestamp":1784215228000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-267568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":16,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,16]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bcr-2025-267568"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-267568","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}