{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T10:51:22Z","timestamp":1783421482429,"version":"3.54.6"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"6","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To characterize the course of therapy in a large cohort of Chinese patients with thyrotoxic periodic paralysis (TPP), a reversible electrolyte emergency fraught with therapeutic challenges.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and methods<\/jats:title><jats:p>In this prospective interventional study, 78 patients with TPP (75 males and three females with an age range of 16\u201348 years) were consecutively enrolled over a 6-year period. Intravenous KCl at a rate of 10\u200ammol\/h was administered until muscle strength recovered. Serum potassium (K<jats:sup>+<\/jats:sup>) and phosphorus concentrations were measured hourly during the paralytic attack and for 6\u200ah after recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The serum potassium (K<jats:sup>+<\/jats:sup>) on attack was 2.1\u00b10.2\u200ammol\/l. The dose of KCl administered to restore muscle strength was 63\u00b132\u200ammol, and peak serum K<jats:sup>+<\/jats:sup> concentration after recovery was 5.3\u00b10.5\u200ammol\/l. A paradoxical fall in serum K<jats:sup>+<\/jats:sup> concentration &gt;0.1\u200ammol\/l difference between presentation and treatment nadir was observed in approximately one-fourth of TPP patients (<jats:italic>n<\/jats:italic>=20). These patients had significantly higher serum-free thyroxine concentration, systolic blood pressure, and heart rate on presentation, as well as serum phosphate concentration on recovery. They not only needed much more KCl supplementation (104\u00b134 vs 48\u00b119\u200ammol, <jats:italic>P<\/jats:italic>&lt;0.001), but also had significantly more severe rebound hyperkalemia (5.8\u00b10.5 vs 5.1\u00b10.4\u200ammol\/l, <jats:italic>P<\/jats:italic>&lt;0.001) on recovery than those who did not have paradoxical hypokalemia. There was a positive correlation between the dose of KCl administered and the difference between peak and nadir serum K<jats:sup>+<\/jats:sup> (\u0394 K<jats:sup>+<\/jats:sup>) (<jats:italic>r<\/jats:italic>=0.68, <jats:italic>P<\/jats:italic>&lt;0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>TPP patients who do not develop paradoxical hypokalemia need a smaller KCl dose to achieve recovery, whereas those who develop paradoxical hypokalemia have more severe hyperthyroidism and hyperadrenergic activity and may require blockage of intracellular K<jats:sup>+<\/jats:sup> shift to prevent rebound hyperkalemia.<\/jats:p><\/jats:sec>","DOI":"10.1530\/eje-09-0553","type":"journal-article","created":{"date-parts":[[2009,9,16]],"date-time":"2009-09-16T03:09:20Z","timestamp":1253070560000},"page":"911-916","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":45,"title":["Therapeutic analysis in Chinese patients with thyrotoxic periodic paralysis over 6 years"],"prefix":"10.1093","volume":"161","author":[{"given":"Jeng-Chuan","family":"Shiang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Jen","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Kai","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Jen","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Juei","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Sen","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-Jye","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Hua","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","container-title":["European Journal of Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/161\/6\/911.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/161\/6\/911.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T16:23:49Z","timestamp":1676391829000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejendo\/article\/161\/6\/911\/6676227"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,12]]},"references-count":0,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.1530\/eje-09-0553","relation":{},"ISSN":["0804-4643","1479-683X"],"issn-type":[{"value":"0804-4643","type":"print"},{"value":"1479-683X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,12]]}}}