Background: Hypokalemic periodic paralysis with thyrotoxicosis has never been described in pregnancy or the puerperium.
Case: A 31-year-old Hispanic woman underwent three prostaglandin inductions for a second-trimester missed abortion. Her management was complicated by hyperthermia, nausea, vomiting, and diarrhea. She developed isolated proximal muscle paralysis and sensory loss on the first post-abortion day. Her serum potassium was 1.5 mEq/L. The serum free thyroxine index exceeded 25 and TSH was below 0.03 μIU/mL, leading to a diagnosis of thyrotoxic hypokalemic periodic paralysis. Oral and parenteral potassium repletion restored full neurologic function, and propylthiouracil treatment was initiated until thyroid ablation could be performed.
Conclusion: Gastrointestinal potassium loss during prostaglandin-induced abortion may unmask previously undiagnosed periodic paralysis.(Obstet Gynecol 1993;82:696-8)
From the Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, Texas.
© 1993 The American College of Obstetricians and Gynecologists