A 37-year-old Hispanic woman complained of having awakened with a ting
ling sensation, followed by sudden weakness, in both legs. A month ear
lier, she had experienced heart palpitations but had not had chest pai
n or dyspnea. She had lost 10 lb in the last two months despite an inc
reased appetite and no polyuria, polydipsia, vomiting, or diarrhea.