Hypokalemic paralysis as primary presentation of Sjögren’s syndrome – A clinical case report

Binay Kumar Mahto; Aditya Prakash; Sant Kumar; Rashmi Kumari

doi:10.51168/sjhrafrica.v5i12.1486

Authors

Binay Kumar Mahto Bhagwan Mahavir Institute of Medical Sciences Pawapuri Nalanda
Aditya Prakash Bhagwan Mahavir Institute of Medical Sciences, Pawapuri, Nalanda, Bihar
Sant Kumar Bhagwan Mahavir Institute of Medical Sciences, Pawapuri, Nalanda, Bihar
Rashmi Kumari Bhagwan Mahavir Institute of Medical Sciences, Pawapuri, Nalanda, Bihar

DOI:

https://doi.org/10.51168/sjhrafrica.v5i12.1486

Keywords:

Sjogren syndrome, hypokalemia, hypokalemic paralysis, renal tubular acidosis

Abstract

Sjogren’s syndrome is an autoimmune rheumatic disease characterized by lymphocytic infiltration of exocrine glands resulting in multi system presentations including xerostomia and dry eyes. A 47-year-old woman presented with generalized weakness, difficulty in walking, nausea and pain abdomen. She had reduced muscle power (2/5) with reduced tone, and absent deep tendon reflexes in all four limbs. Further investigation revealed severe hypokalemia with metabolic acidosis. She was treated with intravenous potassium chloride and diagnosed with Sjogren's syndrome based on her serology profile. After treatment, her condition improved. Hypokalemia occurs due to increased renal excretions of potassium. Distal Renal Tubular Acidosis is a major cause of potassium loss in urine. Sjogren's Syndrome is an important cause of Distal Renal Tubular Acidosis, which can present as severe hypokalemia. Although it commonly presents with symptoms like dry eyes and dry mouth, it can rarely present as Distal Renal Tubular Acidosis and hypokalemia as the primary presentation. Sjogren's syndrome should be suspected in patients with hypokalemia with features of Distal Renal Tubular Acidosis.

Author Biographies

Binay Kumar Mahto , Bhagwan Mahavir Institute of Medical Sciences Pawapuri Nalanda

Senior Resident, Department of Medicine

Aditya Prakash , Bhagwan Mahavir Institute of Medical Sciences, Pawapuri, Nalanda, Bihar

Senior Resident, Department of Medicine

Sant Kumar , Bhagwan Mahavir Institute of Medical Sciences, Pawapuri, Nalanda, Bihar

Senior Resident, Department of Medicine

Rashmi Kumari , Bhagwan Mahavir Institute of Medical Sciences, Pawapuri, Nalanda, Bihar

Professor and Head, Department of Medicine

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