Kortikosteroid ile İndüklenen Hipokalemik Periyodik Paralizi: İki Olgu Sunumu

Hipokalemik periyodik paralizi (HPP) oldukça nadir görülen, kollarda ve bacaklarda ani gelişen yaygın kas kuvvet- sizliği ile seyreden bir hastalıktır. Her iki olgumuzda kortikosteroid enjeksiyonu sonrası gelişen ani yaygın kas kuv- vetsizliği 10 saat içerisinde kendiliğinden düzelmişti. Acil rutin kan tetkiklerinde serum potasyum seviyesi belirgin düşük saptandı. Her iki olgunun uygulanan potasyum replasmanı tedavisi sonrası klinikleri tam düzeldi. Ani gelişen kas kuvvetsizliği ile başvuran hastalarda nadir de olsa HPP'nin akılda bulundurulması önerilmektedir.

Hypokalemic Periodic Paralysis after Administration of Corticosteroid

Hypokalemic periodic paralysis (HPP) is a rare disorder characterised by acute weakness of the upper and lower limbs. We present two cases who developed generalized weakness after corticosteroid injection and totally recovered after 10 hours. The blood tests of the cases revealed hypopotassemia and after replacement treatment they clinically recovered. We intended to present the cases to point out that HPP must be kept in mind in patients applying to the emergency with acute onset of muscle weakness.

PDF

___

Oran M, Bilir B, Şakacı M. ve ark. Hipoka- lemik periyodik paralizi olgusu. IAAOJ, Health Science 2014: 2; 7-10.
Adaş C, Utku U, Utku B ve ark.., Hipoka- lemik periyodik paralizi olgusu. J Kartal TR 2014; 25: 233-234.
Fontaine B, Fournier E, Sternberg D et al..Hypokalemic periodic paralysis: a mo- del for a clinical and research approach to a rare disorder. Neurotherapeutics. 2007; 4:225-232.
Kelley DE, Gharib H, Kennedy FP. et al. Thyrotoxic periodic paralysis. Report of 10 cases and review of electromyographic fin- dings. Arch Intern Med. 1989;149:2597- 2600.
Wessel K, Schumm F, Peiffer J et al. Hy- pokalemic periodic paralysis provoked by "Ambene"Nervenarzt. 1985;56:696-702.
Miyashita Y, Monden T, Yamamoto K, et al. Ventricular fibrillation due to severe hy- pokalemia induced by steroid treatment in a patient with thyrotoxic periodic paraly- sis. Intern Med. 2006;45:11-13.
Liu Z, Braverman LE, Malabanan A.Thy- rotoxic periodic paralysis in a Hispanic man after the administration of predni- sone. Endocr Pract. 2006;12:427-431.
Wongraoprasert S, Buranasupkajorn P, Sridama V, et al. Thyrotoxic periodic pa- ralysis induced by pulse methylpredniso- lone. Intern Med. 2007;46:1431-1433.
Tamez-Pérez HE, Cisneros-Pérez V, Ce- dillo-Rodríguez JA et al. [Prevalence of hy- pokalemia in patients with methylpredni- solone pulse therapy] Rev Invest Clin. 2009;61:194-197.
Kung AW. Clinical review: Thyrotoxic peri- odic paralysis: a diagnostic challenge. J Clin Endocrinol Metab. 2006;91:2490-2495.
Clausen T. Na+-K+ pump regulation and skeletal muscle contractility. Physiol Rev. 2003;83:1269-1324.
Ryan DP, da Silva MR, Soong TW,et al.Mu- tations in potassium channel Kir2.6 cause susceptibility to thyrotoxic hypokalemic pe- riodic paralysis. Cell. 2010 8;140:18.