Article Text
PDF
Abstract
We report the case of a female in her 40s who presented to our emergency department with acute weakness in all limbs for 1 day. Clinical examination alongside point-of-care investigations confirmed acute areflexic flaccid quadriparesis due to severe hypokalaemia. She was found to have distal renal tubular acidosis on further investigation. A detailed clinical history and judicious use of laboratory diagnostic services systematically ruled out idiopathic cause of distal renal tubular acidosis. Neglected sicca symptoms were retrospectively unearthed after a positive Schirmer’s test. A diagnosis of Sjögren’s disease was considered after initial auto-immune screening. Subsequent definitive serology tested positive for anti-Sjogren’s syndrome-associated antigens A (SS-A) and B (SS-B). This case is distinct in that the presenting symptom of Sjögren’s disease was acute areflexic quadriparesis. We hope to highlight Sjögren’s disease as a likely differential for seemingly idiopathic renal tubular acidosis even in the absence of overt sicca symptoms.
- Sjogren's syndrome
- Fluid electrolyte and acid-base disturbances
Statistics from Altmetric.com
Footnotes
Contributors The following authors were responsible for drafting the text, sourcing and editing clinical images, investigating results, drawing original diagrams and algorithms and critically revising important intellectual content: BK and PM. The following authors gave final approval of the manuscript: BK and PM. The guarantor is PM.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.