A case of hypokalemic paralysis secondary to distal renal tubular acidosis as a presenting symptom in Sjogrens syndrome

6^th Annual conference on Clinical & Pediatric Nephrology

May 09-10, 2016 New Orleans, USA

G Mariam Alikhan

Washington University, USA

Posters & Accepted Abstracts: J Nephrol Ther

Abstract :

Sjogrens syndrome is a chronic inflammatory disease characterized by lymphocytic infiltration of the exocrine glands, particularly the lacrimal and salivary glands. Secondary Sjogrens is found in patients with existing autoimmune diseases such as rheumatoid arthritis or systemic lupus erythematosus. Extraglandular manifestations of Sjogrens such as distal rental tubular acidosis are well reported in the literature, however hypokalemic paralysis associated with distal RTA is a much rarer complication. Here, we present a case of a 41 year old female with a history of SLE and RA who presented to our facility with bilateral lower extremity paralysis of one day duration. Patient was evaluated by neurology with an initial differential diagnosis of Guillian Barre, cervical lesion in her spinal cord or Myasthenic crisis. Initial lab work revealed a severe non-anion gap metabolic acidosis with a positive urine anion gap and severely depleted potassium (K=1.4). Patient was immediately started on potassium supplementation and IVIG, however her weakness progressed to her upper extremities and patient subsequently developed hypercapnic respiratory failure requiring intubation and mechanical ventilation. Patient�s acidosis was corrected with a sodium bicarbonate infusion and her hypokalemia eventually improved with aggressive potassium supplementation. She was weaned from the ventilator and downgraded from the ICU. Further workup revealed positive anti-SSA antibodies indicating secondary Sjogrens syndrome although patient did not report xerostomia or sicca like symptoms. This case is an uncommon presentation of Sjogrens associated distal RTA presenting as hypokalemic paralysis.

Biography :

Email: alexander.mariam@mayo.edu