Abstract
A 73 year old white man presented with life threatening hypokalaemic paralysis requiring admission to an intensive care unit. Biochemical investigations showed severe hypokalaemia with hyperchloraemic metabolic acidosis, a spot urine pH of 6.5, and a positive urinary anion gap, establishing the diagnosis of distal renal tubular acidosis. Autoimmune tests revealed Sjögren syndrome as the underlying cause of the distal renal tubular acidosis. Full recovery followed potassium and alkali replacement. This dramatic presentation of Sjögren syndrome has not previously been reported in an elderly man.
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Selected References
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- Christensen K. S. Hypokalemic paralysis in Sjögren's syndrome secondary to renal tubular acidosis. Scand J Rheumatol. 1985;14(1):58–60. doi: 10.3109/03009748509102018. [DOI] [PubMed] [Google Scholar]
- Crooks G. W., Zweiman B. An unusual presentation of Sjögren's syndrome. Clin Diagn Lab Immunol. 1996 Jul;3(4):483–484. doi: 10.1128/cdli.3.4.483-484.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dowd J. E., Lipsky P. E. Sjögren's syndrome presenting as hypokalemic periodic paralysis. Arthritis Rheum. 1993 Dec;36(12):1735–1738. doi: 10.1002/art.1780361213. [DOI] [PubMed] [Google Scholar]
- Rowbottom S. J., Ray D. C., Brown D. T. Hypokalemic paralysis associated with renal tubular acidosis. Crit Care Med. 1987 Nov;15(11):1067–1068. doi: 10.1097/00003246-198711000-00017. [DOI] [PubMed] [Google Scholar]
- Siamopoulos K. C., Elisaf M., Drosos A. A., Mavridis A. A., Moutsopoulos H. M. Renal tubular acidosis in primary Sjögren's syndrome. Clin Rheumatol. 1992 Jun;11(2):226–230. doi: 10.1007/BF02207962. [DOI] [PubMed] [Google Scholar]
- Zimhony O., Sthoeger Z., Ben David D., Bar Khayim Y., Geltner D. Sjögren's syndrome presenting as hypokalemic paralysis due to distal renal tubular acidosis. J Rheumatol. 1995 Dec;22(12):2366–2368. [PubMed] [Google Scholar]
- el-Mallakh R. S., Bryan R. K., Masi A. T., Kelly C. E., Rakowski K. J. Long-term low-dose glucocorticoid therapy associated with remission of overt renal tubular acidosis in Sjögren's syndrome. Am J Med. 1985 Oct;79(4):509–514. doi: 10.1016/0002-9343(85)90040-3. [DOI] [PubMed] [Google Scholar]