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Resume Introduction La paralysie periodique thyreotoxique est habituellement decrite au sein des populations asiatiques. Elle est rare chez le caucasien, et exceptionnelle dans la race noire. Exegese Nous rapportons deux cas de tetraplegie hyporeflexique generalisee avec hypokaliemie. Dans le premier cas, l'hyperthyroidie est decouverte a cette occasion, et l'apparition de complications respiratoires et cardiaques conduit a un transfert en reanimation. Dans le second cas, alors que l'hyperthyroidie est connue mais decompensee par insuffisance therapeutique, les signes neurologiques regressent spontanement. Conclusion Devant tout acces paralytique hypokaliemique, un controle des hormones thyroidiennes est requis, meme en l'absence de tous signes peripheriques, et ce quelle que soit la race.

Resume Introduction . — Les effets secondaires des immunoglobulines intraveineuses a fortes doses sont le plus souvent benins. Cependant, des cas d’insuffisance renale aigue et plus rarement d’infarctus cerebral ont ete decrits. Il n’y a pas a notre connaissance de cas rapporte cumulant ces deux types de complications severes. Exegese . — Une insuffisance renale aigue severe et un infarctus de l’artere choroidienne anterieure droite sont survenus simultanement 2 jours apres une cure d’immunoglobulines intraveineuses a 2 g/kg chez un patient purpura thrombopenique idiopathique. De plus, l’infarctus cerebral s'est aggrave a la suite d’une seconde cure d’immunoglobulines intraveineuses a 1 g/kg. Une etude clinique et neuroradiologique a ete realisee chez ce patient. Conclusion . — Un traitement par immunoglobulines intraveineuses a fortes doses necessite une surveillance rigoureuse de la fonction renale et la limitation des doses pour eviter la survenue d’un accident thrombotique.

Thyreotoxic hypokalemic periodic paralysis (THPP) has mainly been described in Asian people. It is rare in Caucasians, and only 12 cases were reported in Blacks.We report two cases of THPP in black patients. Hypokalemia was important in case number 1, leading to severe flaccid tetraplegia with respiratory and cardiac complications, but was only mild in case number 2. Complete relief of paralysis was observed under potassic treatment in the first case and spontaneously in the second one. Hyperthyroidism was established only on the basis of biological tests in case number 1, and had been previously diagnosed but undertreated in case number 2.Whatever the patient's race, acute paralysis with hypokalemia requires testing for hyperthyroidism, even in the absence of suggestive clinical signs.

Side-effects of immunoglobulins administered via the intravenous route are usually minor. However, acute renal failure and more rarely thrombotic events, including ischemic stroke, have been reported in association with immunoglobulin infusion. To our knowledge, no case of both acute failure and stroke following immunoglobulin has been described until now.Two days after immunoglobulin infusion (2 g/kg), a patient who presented with autoimmune thrombocytopenia suffered severe acute renal failure associated with an ischemic stroke in the right anterior choroid artery territory. Moreover, the stroke worsened immediately following a second infusion (1 g/kg). Clinical and neuroradiological examinations were conducted.Results indicate the need for both close monitoring of serum creatinine and diuresis before starting immunoglobulin therapy, and limiting the total dose to prevent thrombotic events such as stroke.