Hypokalemic quadriparesis due to renal tubular acidosis in a patient with Sjögren’s syndrome: A case series

Sjögren’s syndrome is a slowly progressing autoimmune disease characterized by lymphocytic infiltration of the exocrine glands, mainly the lacrimal and salivary glands, resulting in their impaired secretory function. Systemic involvement and symptoms of cutaneous, respiratory, renal, hepatic, neurologic, and vascular systems often occur.1 Renal involvement is a well recognized extra glandular manifestation and may be related to chronic interstitial nephritis. The resultant tubular dysfunction may manifest as proximal or distal renal tubular acidosis, tubular proteinuria or nephrogenic diabetes insipidus.2,3 Renal tubular acidosis occurs almost 25-40% of patients with Sjogren syndrome.4 renal manifestations like hypokalemic periodic paralysis, urolithiasis, or osteomalacia are uncommon.1 Hypokalemic paralysis secondary to Sjogren’s syndrome with distal renal tubular acidosis is rarely seen in our patients population. We report a case of flaccid quadriparesis in a patient with Sjogren syndrome. Our aim is to emphasize one of the rare presentations of Sjogren’s syndrome but also to highlight the favourable response to potassium and bicarbonate therapy.