title: Recurrent Attacks of Hypokalemic Quadriparesis: An Unusual Presentation of Primary Sjögren Syndrome.
abstract: We herein report the case of a 64-year old woman with recurrent attacks of hypokalemic quadriparesis which resulted from distal renal tubular acidosis (dRTA) secondary to Sjögren syndrome. The patient presented with sudden onset quadriparesis. A physical examination showed symmetric weakness of all four limbs. Severe hypokalemia (1.8 mEq/L), accompanied by normal anion gap metabolic acidosis, a positive urine anion gap and an inappropriately high urine pH pointed toward the diagnosis of dRTA. Further investigations disclosed primary Sjögren syndrome, which had not previously been recognized. On the basis of the current report and a review of the literature we suggest investigating the possibility of Sjögren syndrome in all patients with clinically unexplained dRTA.
authors.affiliation: Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Iran.
authors.forename: Shiva
authors.initials: S
authors.lastname: Seirafian
authors.forename: Mohammad
authors.initials: M
authors.lastname: Shafie
authors.forename: Amin
authors.initials: A
authors.lastname: Abedini
authors.forename: Bahram
authors.initials: B
authors.lastname: Pakzad
authors.forename: Peyman
authors.initials: P
authors.lastname: Roomizadeh
mesh_terms: D000136:Acid-Base Equilibrium; D000141:Acidosis, Renal Tubular / Q000150:complications*; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000209:etiology*; D008875:Middle Aged; D018908:Muscle Weakness; D012859:Sjogren's Syndrome / Q000503:physiopathology*