Potassium Therapy in Patients with Hypokalemic Periodic Paralysis in RSUD Kabupaten Empat Lawang: A Case Report

Potassium Therapy in Patients with Hypokalemic Periodic Paralysis in RSUD Kabupaten Empat Lawang: A Case Report

Authors

  • Sintia Eka Aprilia General Practitioner, Empat Lawang Regency Regional General Hospital, South Sumatera, Indonesia
  • Oktavianus Tambun Neurology Consultant, Empat Lawang Regency Regional General Hospital, South Sumatera, Indonesia

Keywords:

hypokalemic, periodic paralysis, potassium therapy

Abstract

Introduction: Hypokalemic periodic paralysis (HypoPP) is a rare skeletal muscle channelopathy characterized by episodic attacks of moderate to severe flaccid muscle tetraparesis accompanied by hypokalemia. This case report aims to discuss the case and management of hypokalemic periodic paralysis with potassium therapy at RSUD Kabupaten Empat Lawang. Case Presentation: A 29-year-old female presented with sudden bilateral limb weakness, vomiting, and nausea. She had no breathing, swallowing issues, or pain. Physical examination showed reduced muscle strength and epigastric tenderness. Laboratory tests indicated elevated leukocytes and decreased kalium. Diagnosed with hypokalemic periodic paralysis and a UTI, she received IV fluids, potassium chloride, and other supportive treatments, leading to immediate condition resolution. Conclusion: Hypokalemic Periodic Paralysis (HypoPP) is a rare neuromuscular disorder characterized by periodic muscle weakness ranging from mild to complete paralysis.. The etiology in this case was secondary to hyperemesis. Failure to diagnose and manage periodic paralysis can be fatalIt can lead to respiratory failure and death. Treatment involves potassium supplementation and monitoring for cardiac complications.

References

Kardalas E, Paschou SA, Anagnostis P, Muscogiuri G, Siasos G, Vryonidou A. Hypokalemia: a clinical update. Endocr Connect. 2018;7(4):R135-R146. doi:10.1530/EC-18-0109

Stapleton LJ. Hypokalaemia periodic paralysis. Scott Med J. 2018;63(1):28-31. doi:10.1177/0036933017727420

Chandramohan G, Dineshkumar T, Arul R, et al. Spectrum of Hypokalemic Paralysis from a Tertiary Care Center in India. Indian J Nephrol. 2018;28(5):365. doi:10.4103/ijn.IJN_225_17

Payus AO, Liew SL, Tiong N, Mustafa N. Hypokalaemic periodic paralysis secondary to subclinical hyperthyroidism: an uncommon cause of acute muscle paralysis. BMJ Case Rep CP. 2021;14(6):e240666. doi:10.1136/bcr-2020-240666

Basali D, Prayson RA. Episodic weakness and vacuolar myopathy in hypokalemic periodic paralysis. J Clin Neurosci. 2015;22(11):1846-1847. doi:10.1016/j.jocn.2015.06.006

Chalissery AJ, Munteanu T, Langan Y, Brett F, Redmond J. Diverse phenotype of hypokalaemic periodic paralysis within a family. Pract Neurol. 2018;18(1):60-65. doi:10.1136/practneurol-2017-001677

Tachamo N, Lohani S, Nazir S, Juliano N. Paralysis that easily reverses: a case of thyrotoxic periodic paralysis. Case Rep. 2017;2017:bcr2016218951. doi:10.1136/bcr-2016-218951

Baldane S, Ipekci SH, Celik S, Gundogdu A, Kebapcilar L. Hypokalemic paralysis due to thyrotoxicosis accompanied by Gitelman’s syndrome. Indian J Nephrol. 2015;25(2):103. doi:10.4103/0971-4065.140719

Holm-Yildiz S, Witting N, Dahlqvist J, et al. Permanent muscle weakness in hypokalemic periodic paralysis. Neurology. 2020;95(4):e342-e352. doi:10.1212/WNL.0000000000009828

Lybecker MB, Madsen HB, Bruun JM. Severe hypokalaemia as a cause of acute transient quadriparesis. Case Rep. 2017;2017:bcr. doi:10.1136/bcr-2017-220735

Kumar A, Ovung MR. A Case Report on Hypokalemic Quadriparesis. J Clin Pharm Res. Published online April 28, 2022:22-24. doi:10.61427/jcpr.v2.i2.2022.56

Islam AKMM, Roy S, Zaman S, Ahmed F, Rahim M, Jesmin H. Hypokalemic Periodic Paralysis: Reports of Two Cases and Brief Review. BIRDEM Med J. 2019;9:74-79. doi:10.3329/birdem.v9i1.39729

Agrawal A. Clinical Profile in Hypokalemic Periodic Paralysis Cases. Eur J Gen Med. 2014;11(1):6-9. doi:10.15197/sabad.1.11.02

Segal MM, Jurkat-Rott K, Levitt J, Lehmann-Horn F. Hypokalemic periodic paralysis – an owner’s manual. Published online 2017.

Khan MAA, Minalyan A, Iqbal I. “I Can’t Move My Arms and Legs”: A Rare Cause of Hypokalemia-Induced Quadriparesis. Cureus. 13(7):e16114. doi:10.7759/cureus.16114

Coimbra TM, Terrim S, Silva GD. Secondary Hyperkalemic Paralysis: a Case Report and an Update Review of 128 Cases. JBMEDE - J Bras Med Emergência. 2021;1(3):e21023-e21023. doi:10.54143/jbmede.v1i3.36

Stunnenberg BC, Deinum J, Links TP, Wilde AA, Franssen H, Drost G. Cardiac arrhythmias in hypokalemic periodic paralysis: Hypokalemia as only cause? Muscle Nerve. 2014;50(3):327-332. doi:10.1002/mus.24225

Radhakrishan S, Sundari M, Dev A. A Case Series Of Periodic Approach To Hypokalemic Periodic Paralysis - The Paralysis By The Potassium. J Pharm Negat Results. 2022;13(5).

Clossey DG, Martin A, Im DD, Reisner AT, Wittels K, Wilcox SR. A Rare Cause of Quadriparesis. J Emerg Med. 2020;58(3):506-508. doi:10.1016/j.jemermed.2019.11.021

Rahmani SH, Faridaalaee G. Accidental intravenous bolus infusion of potassium chloride in a young man with hypokalemic periodic paralysis. J Emerg Pract Trauma. 2019;5(1):29-31. doi:10.15171/jept.2017.34

Subramani J, Muthaiah M. Unusual Case of Acute Flaccid Quadriparesis in South India. Br J Med Med Res. 2016;11:1-5. doi:10.9734/BJMMR/2016/21942

Palmer BF. Regulation of Potassium Homeostasis. Clin J Am Soc Nephrol CJASN. 2015;10(6):1050-1060. doi:10.2215/CJN.08580813

Downloads

Published

2024-08-28

How to Cite

Potassium Therapy in Patients with Hypokalemic Periodic Paralysis in RSUD Kabupaten Empat Lawang: A Case Report (S. E. Aprilia & O. Tambun , Trans.). (2024). The Indonesian Journal of General Medicine, 3(1), 1-10. https://doi.org/10.70070/z3w0tq50