Abstract
Potassium supplements have been recommended to hasten recovery and prevent cardiopulmonary
complications in patients with thyrotoxic periodic paralysis (TPP). However, this
recommendation has not yet been proven efficacious. Thirty-two patients with acute
attacks of TPP over a 3-year-period were divided into 2 groups. Group A (n = 12) was
a control group treated with normal saline infusion 125 mL/hr only. Group B (n = 20)
received intravenous KCl administration at a rate of 10 mmol/hr in normal saline 125
mL/hr. During the attack and for 6 hours after muscle recovery, hemodynamics were
continuously recorded and muscle strength and plasma K+ concentration were measured hourly. The sex, age, muscle strength, thyroid function,
biochemical values including plasma K+ levels, as well as the time from attack to therapy (3.6 ± 1.6 v 3.3 ± 1.0 hr) were not significant between the 2 groups. However, recovery time was
significantly shorter in the KCl group than the control (6.3 ± 3.8 v 13.5 ± 7.5 hr, P < .01). Rebound hyperkalemia greater than 5.5 mmol/L occurred in 40% patients receiving
KCl. The dose of KCl administered and peak K+ concentration were positively correlated (r = 0.85, P < .001). In conclusion, KCl therapy proves to help the recovery of paralysis in TPP
associated with rebound hyperkalemia. KCl supplementation should be given as small
as possible (<10 mmol/hr) to avoid rebound hyperkalemia unless there are cardiopulmonary
complications.
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Article Info
Publication History
Accepted:
September 12,
2003
Received:
July 26,
2003
Footnotes
☆Supported by a grant from the National Science Council, Taiwan (no. NSC 91-2314-B-016-093).
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
