{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:31:38Z","timestamp":1760146298233,"version":"build-2065373602"},"reference-count":13,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T00:00:00Z","timestamp":1728864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Hypokalemia is a common laboratory finding in hospitalized patients, typically resulting from insufficient potassium intake, renal or gastrointestinal losses, or intracellular shifts. While the underlying cause is often easily identifiable, certain cases present diagnostic challenges, and if left unrecognized, the consequences can be life-threatening. We report a rare and atypical case of severe symptomatic hypokalemia as the initial presentation of newly diagnosed Graves\u2019 disease. The condition was caused by thyrotoxic periodic paralysis, a rare but serious complication of thyrotoxicosis, predominantly seen in East Asian populations. This disorder is characterized by episodes of acute, reversible muscle weakness associated with transient hypokalemia, which increases the risk of falls and traumatic injuries. The prompt identification of the etiology in such cases is critical for preventing recurrence and avoiding potentially fatal complications.<\/jats:p>","DOI":"10.3390\/medicina60101685","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T06:46:33Z","timestamp":1728888393000},"page":"1685","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Thyrotoxic Periodic Paralysis: A Rare Cause of Quadriparesis in a Young and Seemingly Healthy Patient"],"prefix":"10.3390","volume":"60","author":[{"given":"Adrian-Gabriel","family":"Florescu","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0591-9169","authenticated-orcid":false,"given":"Evelina-Ioana","family":"Gale\u0219","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabina Adriana","family":"Frunz\u0103","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6837-260X","authenticated-orcid":false,"given":"Camelia Cristina","family":"Diaconu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania"},{"name":"Academy of Romanian Scientists, 050045 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"R135","DOI":"10.1530\/EC-18-0109","article-title":"Hypokalemia: A clinical update","volume":"7","author":"Kardalas","year":"2018","journal-title":"Endocr. Connect."},{"key":"ref_2","unstructured":"Siddamreddy, S., and Dandu, V.H. (2024, May 23). Thyrotoxic Periodic Paralysis, StatPearls, Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK560670\/."},{"key":"ref_3","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":"J. Clin. Endocrinol. Metab."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1093\/qjmed\/89.6.463","article-title":"Thyrotoxic periodic paralysis in a Chinese population","volume":"89","author":"Ko","year":"1996","journal-title":"QJM"},{"key":"ref_5","unstructured":"Iqbal, Q.Z., Niazi, M., Zia, Z., and Sattar, S.B.A. (2024, May 23). A Literature Review on Thyrotoxic Periodic Paralysis. Cureus [Internet]. Available online: https:\/\/www.cureus.com\/articles\/39453-a-literature-review-on-thyrotoxic-periodic-paralysis."},{"key":"ref_6","unstructured":"Gutmann, L., Shefner, J., and Wilterdink, J. (2024). Thyrotoxic periodic paralysis. Uptodate, Wolters Kluwer."},{"key":"ref_7","first-page":"384","article-title":"Thyrotoxic periodic paralysis admitted to the medical department in Qatar","volume":"66","author":"Abbas","year":"2008","journal-title":"Neth. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1681\/ASN.2012010046","article-title":"Mechanism of Thyrotoxic Periodic Paralysis","volume":"23","author":"Lin","year":"2012","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_9","first-page":"21-0178","article-title":"Thyrotoxic periodic paralysis associated with Graves\u2019 disease: A case series","volume":"2022","author":"Ludgate","year":"2022","journal-title":"Endocrinol. Diabetes Metab. Case Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.ajem.2004.09.016","article-title":"Effects of potassium supplementation on the recovery of thyrotoxic periodic paralysis","volume":"22","author":"Lu","year":"2004","journal-title":"Am. J. Emerg. Med."},{"key":"ref_11","first-page":"515","article-title":"Hashimoto thyroiditis amid COVID-19 pandemic: A clinical study","volume":"3","author":"Peretianu","year":"2022","journal-title":"Rom. J. Mil. Med."},{"key":"ref_12","first-page":"63","article-title":"The extent of surgery for unilateral nodular goiter with compression syndrome against the background of autoimmune thyroiditis","volume":"1","author":"Shidlovskyi","year":"2021","journal-title":"Arch. Balk. Med. Union"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/0002-9343(74)90010-2","article-title":"Thyrotoxic periodic paralysis","volume":"57","author":"Yeung","year":"1974","journal-title":"Am. J. 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