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Hypokalaemic quadriparesis with respiratory failure due to latent Sjogren syndrome
  1. Archita Makharia1,
  2. Manoj Lakhotia1,
  3. Mudita Gupta2 and
  4. Pradeep Lalwani1
  1. 1General Medicine, Dr Sampurnanand Medical College, Jodhpur, India
  2. 2Dermatology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
  1. Correspondence to Dr Archita Makharia; archita.makharia{at}


Sjogren’s syndrome (SS) is an autoimmune disease with involvement of multiple organs, including both glandular and extraglandular organs. Usually involvement of glandular organs manifests before the extraglandular ones, but when the sequence is reversed, diagnosis may be missed. Hypokalaemic quadriparesis in SS is not uncommon. Respiratory failure in hypokalaemia is not usually seen, but in SS, it has been reported. We report a case of a 55-year-old woman who presented with sudden onset flaccid quadriparesis and respiratory muscle paralysis secondary to severe hypokalaemia. On detailed investigation, she was detected to have distal renal tubular acidosis secondary to clinically inapparent and asymptomatic SS.

  • immunology
  • nutrition and metabolism
  • connective tissue disease

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  • Contributors AM prepared the manuscript and searched the literature, ML reviewed the manuscript and is responsible for intellectual content, MG searched the literature and PL reviewed the manuscript and searched the literature.

  • 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.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.