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<p>Hypokalemic paralysis (HP) is an uncommon muscular condition marked by intermittent episodes of muscle weakness that, if left untreated, can escalate to respiratory failure as a medical emergency. Type 1 renal tubular acidosis (RTA) or distal renal tubular acidosis (dRTA), which may have genetic or acquired origins, results in impaired kidney function in maintaining a normal acid–base balance. This condition can arise from thyroiditis and may coincide with other autoimmune disorders, leading to potassium loss and failure in urinary acidification. We present a case of a young woman experiencing recurrent, severe hypokalemia along with normal anion gap metabolic acidosis, later diagnosed with distal RTA associated with Hashimoto’s thyroiditis. Hypothyroidism, a commonly encountered thyroid disorder, typically presents identifiable symptoms. However, in certain cases, atypical presentations may pose challenges for accurate diagnosis. Recurrent HP episodes have been documented in thyrotoxicosis. However, HP with hypothyroidism has poor reportage in existing literature, so much so that this is only the 38th case reported thus far to the best of our knowledge.</p>

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A rare case of hypokalemic paralysis in hypothyroidism: distal renal tubular acidosis in a case of Hashimoto's thyroiditis

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  • 发表日期：

    2025年1月24日

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  • Tanmayee Mareedu,
  • Pratyush Sachdeva,
  • Patel Soham,
  • Vindlacheruvu Srividya,
  • Mudit Moondra,
  • Lahari Katta,
  • Sweta Sahu

摘要

Hypokalemic paralysis (HP) is an uncommon muscular condition marked by intermittent episodes of muscle weakness that, if left untreated, can escalate to respiratory failure as a medical emergency. Type 1 renal tubular acidosis (RTA) or distal renal tubular acidosis (dRTA), which may have genetic or acquired origins, results in impaired kidney function in maintaining a normal acid–base balance. This condition can arise from thyroiditis and may coincide with other autoimmune disorders, leading to potassium loss and failure in urinary acidification. We present a case of a young woman experiencing recurrent, severe hypokalemia along with normal anion gap metabolic acidosis, later diagnosed with distal RTA associated with Hashimoto’s thyroiditis. Hypothyroidism, a commonly encountered thyroid disorder, typically presents identifiable symptoms. However, in certain cases, atypical presentations may pose challenges for accurate diagnosis. Recurrent HP episodes have been documented in thyrotoxicosis. However, HP with hypothyroidism has poor reportage in existing literature, so much so that this is only the 38th case reported thus far to the best of our knowledge.