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Reminder of important clinical lesson
Primary Sjögren's disease and its complications presenting with progressive paralysis
  1. Matthew Julian1,
  2. Trishna Chakravorty2,
  3. Philip Dyer3
  1. 1Critical Care Department, Heartlands Hospital, Birmingham, UK
  2. 2Department of Acute Medicine, Heartlands Hospital, Birmingham, UK
  3. 3Diabetes and Endocrinology, Diabetes Centre, Heartlands Hospital, Birmingham, UK
  1. Correspondence to Dr Matthew Julian, mattjulian{at}doctors.org.uk

Summary

A 24-year-old female presented with generalised weakness, lethargy and aches in legs. She was subsequently found to be markedly hypokalaemic and have a metabolic acidosis. A diagnosis of distal renal tubular acidosis (RTA) was made. In addition to this failure to alkalinise her urine, she was unable to concentrate it and so a diagnosis of nephrogenic diabetes insipidus was reached. Further questioning revealed previous investigation of a connective tissue disorder thought to be primary Sjögren's syndrome. RTA is a recognised but rare complication of Sjögren's syndrome. Urinary alkalinisation using potassium bicarbonate was instituted; the patient responded well to treatment and is having outpatient follow-up.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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