Hypokalemic paralysis revealing Sjögren's syndrome

A rare case of a lady with acute hypokalemic quadriparesis and underlying distal renal tubular acidosis manifesting as a presentation of Sjögren's syndrome is described. The case highlights the concept that acute hypokalemia due to unrecognized renal tubular acidosis may unmask Sjögren's syndrome in patients without sicca symptoms and it may be a marker of more severe renal disease. Acute paralysis is a life threatening consequence of hypokalemia and when due to potassium wasting secondary to renal tubular acidosis may be easily prevented. Underlying Sjögren's syndrome should be considered in all patients of either sex and at any age presenting with hypokalemic paralysis.