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Insulin-induced severe thyrotoxic periodic paralysis:A case report

World Journal of Clinical Cases 2025年第7期13卷 46-51页

作者： Yan-Li Wang Jian Li Department of Endocrinology and Metabolism Zigong First People's HospitalZigong 643000Sichuan ProvinceChina

BACKGROUND thyrotoxic periodic paralysis(TPP)is an endocrine emergency caused by thyrotoxicosis,manifesting mainly as periodic myasthenia and hypokalemia,and posing a serious threat to the patient's ***,strenuous exercise,alcohol abuse,high carbohydrate intake and insulin injections are common triggers of *** article reports a case of severe TPP induced by insulin injection,elucidates the characteristics and pathogenesis of the disease,analyses the risk factors for triggering TPP,and hopefully provides more clinical data for TPP *** SUMMARY A 38-year-old Asian man presented to the emergency department with a oneweek history of limb weakness and worsening *** medical history included poorly controlled type 2 diabetes and he had been switched to Aspart50 a week *** was alert and oriented with upper extremity strength grade 3 and lower extremity strength grade *** department tests showed hypokalemia of 1.6 mmol/*** paramedics administered 1.5 g of potassium intravenously,followed by 4.0 g *** in the arms and legs *** was referred to endocrinology where he was diagnosed with Graves'disease,with suboptimal control and insulin injections possibly causing *** stopped his insulin and he was discharged with a potassium level of 4.0 mmol/*** Insulin is a trigger for TPP and should be avoided in patients with *** recognition and treatment of TPP is crucial,especially in patients presenting with hypokalemic periodic paralysis.

关键词： thyrotoxic periodic paralysis Potassium metabolism disorders Insulin Triggers of paralysis Case report

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Acute myocarditis presenting as accelerated junctional rhythm in Graves’disease:A case report

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World Journal of Clinical Cases 2021年第35期9卷 11085-11094页

作者： Meng-Mei Li Wei-Sheng Liu Rui-Cai Shan Jun Teng Yan Wang Department of Emergency Medicine Qingdao Central HospitalAffiliated Qingdao Central HospitalQingdao UniversityQingdao 266042Shandong ProvinceChina Department of Abdominal Ultrasonography Qingdao Central HospitalAffiliated Qingdao Central HospitalQingdao UniversityQingdao 266042Shandong ProvinceChina

BACKGROUND Acute myocarditis is an acute myocardium injury that manifests as arrhythmia,dyspnea,and elevated cardiac *** myocarditis is usually caused by a viral infection but can sometimes be caused by ***’disease is an autoimmune disease that is a rare etiology of acute *** junctional rhythm is also a rare manifestation of acute myocarditis in *** SUMMARY A rare case of new-onset Graves’disease combined with acute myocarditis and thyrotoxic periodic paralysis is *** patient was a 25-year-old young man who suddenly became paralyzed and felt palpitations and *** was then sent to our emergency department(ED).Upon arrival,electrocardiography revealed an accelerated junctional rhythm and ST-segment depression in all leads,and laboratory findings showed extreme hypokalemia and elevated troponin I,with the troponin I level being 0.32 ng/mL(reference range,0-0.06 ng/mL).Coronary computer tomography angiography was performed,and there were no abnormal findings in the coronary ***,the patient was admitted to the ED ward,where further testing revealed Graves’disease,along with continued elevated cardiac enzyme levels and B-type natriuretic peptide(BNP)*** troponin I level was 0.24 ng/mL after *** of the echocardiography results were normal:Left atrium 35 mm,left ventricle 48 mm,end-diastolic volume 102 mL,right atrium 39 mm×47 mm,right ventricle 25 mm,and ejection fraction 60%.Cardiac magnetic resonance was performed on the fifth day of admission,revealing myocardial edema in the lateral wall and intramyocardial and subepicardial late gadolinium enhancement in the lateral apex,anterior lateral,and inferior lateral segments of the *** patient refused to undergo an endomyocardial *** 6 d,the patient’s cardiac enzymes,BNP,potassium,and electrocardiography returned to *** the patient’s symptoms were relieved,he was discharged from the ***

关键词： Graves’disease Myocarditis thyrotoxic periodic paralysis Accelerated junctional rhythm Case report

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