HYPOKALEMIC PARALYSIS AS A PRESENTING FEATURE OF PRIMARY SJOGREN'S SYNDROME: A SERIES OF 6 CASES

Santhosh Kumar Arepalli, Gayatri Kammila, Kothamasu Dinesh, Mandalapu Navya

Abstract


We describe here a series of 13 cases who presented with hypokalemic paralysis secondary to distal Renal tubular acidosis(RTA). All the patients presented with quadriparesis and were  found to have hypokalemia on investigation. Blood gas analysis revealed the picture of acidosis with normal anion gap and urinary pH > 5.5, suggestive of distal RTA. All the patients received intravenous potassium and bicarbonate supplementation and quadriparesis improved over 4-72 hours. Out of the 13 cases, etiology of distal RTA was found to be Primary Sjogren’s syndrome(PSS) in 6 cases. All the 6 patients were positive for anti-Ro or anti-La antibodies, and lip biopsy was positive in 3 patients. History of sicca symptoms was present only in 2 of the 6 patients. In our series Sjogren’s syndrome accounted for 46.1% of  RTA cases. Renal involvement in Sjogren’s syndrome is common and may precede sicca symptoms. Sjogren’s syndrome is one of the best documented cause of distal RTA.

         To conclude, renal involvement in PSS can uncommonly present as hypokalemic paralysis in the absence of significant sicca symptoms or may precede sicca symptoms.

Keywords


Hypokalemic paralysis, distal RTA, Primary Sjogren’s syndrome

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References


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