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  • Title: Hypokalaemic paralysis as the initial clinical presentation of Sjogren's syndrome induced distal renal tubular acidosis.
    Author: Kielty JM, Ryan P, Sexton D, Kelly YP.
    Journal: BMJ Case Rep; 2021 May 06; 14(5):. PubMed ID: 33958361.
    Abstract:
    A 41-year-old woman presented by ambulance with a 1-day history of new-onset paralysis and nausea and vomiting ongoing for 48 hours. She had no history of any similar episodes. Biochemical analysis showed profound hypokalaemia with a non-anion gap metabolic acidosis. Her initial serum chloride was within the normal range. She had significant electrocardiographic changes on admission with ST depression, U waves and a prolonged QT interval. Urinary anion gap supported the diagnosis of a distal renal tubular acidosis. Subsequent connective tissue disease serology confirmed previously undiagnosed Sjogren's syndrome. Successful recovery for this patient required multidisciplinary input from the intensive care, nephrology and neurology teams.
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