Annals of Tropical Medicine and Public Health
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CASE REPORT
Year : 2013  |  Volume : 6  |  Issue : 3  |  Page : 312-314

Hypokalemic Quadriparesis in a female-The marker for Sjogren's syndrome


1 Department of Medicine, Sher-I-Kashmir Institute of Medical Sciences, Medical College and Hospital, Srinagar, Jammu and Kashmir, India
2 Department of Nephrology, Sher-I-Kashmir Institute of Medical Sciences, Medical College and Hospital, Srinagar, Jammu and Kashmir, India

Correspondence Address:
Muzafar Naik
Department of Medicine, Sher-I-Kashmir Institute of Medical Sciences, Medical College and Hospital, Srinagar, Kashmir - 190 011
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.120992

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Sjogren's syndrome (SS) is a multi-systemic autoimmune disorder characterized especially by lymphocytic infiltration of exocrine glands. Renal involvement in SS is commonly manifested by tubular dysfunction. A 35 years old female presented to the emergency department with weakness of all four limbs. The baseline investigations in Emergency Department (ED) revealed hypokalemic normal anion gap metabolic acidosis. On further questioning there was history of dryness of mouth, eyes and multiple dental extractions for the last two years. Clinical and biochemical assessment confirmed a diagnosis of SS with type 1 Renal Tubular Acidosis (RTA). Hypokalemic quadriparesis associated with SS is mainly due to type 1 RTA and it can precede the sicca symptoms. We hereby report a case of primary SS with long standing sicca symptoms in which the diagnosis of SS was suspected only after the hypokalemic paralysis. The case highlights the significance of presentation of acute hypokalemia in the ED as it can unmask SS even if it is associated with sicca symptoms. Hypokalemic paralysis if associated with normal anion gap metabolic acidosis should prompt towards diagnosis of SS.


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