PARALISIA PERIÓDICA HIPOCALIÉMICA – UMA CAUSA RARA DE TETRAPARÉSIA EM EUROPEUS | HYPOKALAEMIC PERIODIC PARALYSIS – A RARE CAUSE OF TETRAPARESIS IN EUROPEAN PEOPLE
Resumo
PT:
A paralisia periódica hipocaliémica é uma complicação neurológica do hipertiroidismo, especialmente na doença de Gra-
ves, rara em não asiáticos. Caracteriza-se por episódios auto-limitados recorrentes de fraqueza muscular que afecta sobretu-
do os músculos proximais dos membros inferiores. Acompanha-se de hipocaliémia, potencialmente grave.
Apresenta-se o caso de um doente de 39 anos, caucasiano, com doença de Graves, medicado com carbimazol. Durante
3 meses, teve episódios recorrentes de tetraparésia de predomínio proximal, de curta duração, que surgiam após períodos
de repouso, motivo pelo qual foi internado. Por manter episódios de agravamento da tetraparésia, associados a hipocalié-
mia e hipomagnesiémia, e por, laboratorialmente, apresentar hipertiroidismo, admitiu-se a hipótese de paralisia periódica
hipocaliémica e iniciou terapêutica com tiamazol, corticoterapia, propranolol e reposição iónica, verificando-se melhoria
progressiva.
O caso exposto é um exemplo de uma situação incomum, em que a suspeita clínica é fundamental, porque o diagnóstico
pode ser difícil. A terapêutica precoce do hipertiroidismo é imprescindível.
Palavras-chave: Hipertiroidismo; Doença de Graves; Paralisia periódica hipocaliémica.
EN:
Hypokalaemic periodic paralysis is a neurological complication of hyperthyroidism, especially in Graves disease, rare in non-Asiatic peo-
ple. This condition is characterized by recurrent self-limited episodes of muscular weakness, which mostly affects proximal muscles of lower
extremities. It may be accompanied by hypokalaemia, eventually severe.
We present a case of a 39-year-old male patient, Caucasian, with Graves disease, treated with carbimazole. Over the previous 3 months,
he had had recurrent episodes of tetraparesis with proximal predominance, within short periods, which emerged after rest. For that reason he
was hospitalised. Because he still had worsening episodes of tetraparesis, with hypokalaemia and hypomagnesaemia, and hyperthyroidism, we
admitted the diagnostic hypothesis of hypokalaemic periodic paralysis. Therefore, he initiated thiamazole, corticotherapy, propranolol and ion
replacement, having progressive improvement.
This case is an example of an uncommon situation, in which clinical suspicion is fundamental, because diagnosis can be difficult. Early
treatment of hyperthyroidism is imperative.
Key words: Hyperthyroidism; Graves disease; Hypokalemic periodic paralysis.
Texto Completo:
PDFReferências
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