Recurrent Hypokalaemic Paresis in Secondary Sjögren’s Syndrome

Abstract

Hypokalaemia has a wide scale of causes. The most common ones include potassium loss from urinary tract, gastrointestinal system and loss through sweating. This is report is about a young 24-year-old Indian female who presented with sudden onset weakness of all four limbs which was found to be secondary to hypokalaemia. Refractory hypokalaemia and severe metabolic acidosis in this patient led to further work-up, which revealed positive Anti-SSA (anti-Sjögren’s-syndrome-related antigen A autoantibodies), AntiSSB Anti-Sjögren’s syndrome type B and Anti-snRNP (Small nuclear ribonucleoprotein), strongly suggestive of secondary Sjögren’s syndrome. Renal involvement with distal Renal Tubular Acidosis (RTA) causing hypokalaemia is seen in 10% of cases with Sjögren’s syndrome. Thus, this report highlights the unusual initial presentation of hypokalaemic paresis in a patient with Sjögren’s syndrome, and to emphasise that an autoimmune disorder should be considered in such presentations.