Acute Flaccid Quadriparesis Because of a Rare Systemic Cause

Sjogren's syndrome is a chronic slowly progressive autoimmune disease characterized by lymphocytic infiltration of exocrine glands resulting in xerostomia and dry eyes. The syndrome has wide clinical spectrum from organ specific exocrionopathy to systemic manifestation. The disease can present alone or with other autoimmune diseases like RA, SLE, Scleroderma, autoimmune thyroid disease etc. Prevalence of primary Sjogren's is 0.5-1% and of secondary Sjogren's is 5-20%. Renal involvement is rare and can either be tubulointerstial or glomerular. Based on biopsy reports in the available literature, tubulointerstitial nephritis (TIN) is the most common histological abnormality, followed by glomerulonephritis as a distant second.1 Distal Renal tubular Acidosis is the most common manifestation of TIN. We report a case of a 35 year female with acute onset motor weakness (quadriparesis) with hypokalemia with NAGMA with distal RTA. Patient was diagnosed with Secondary Sjogren's and managed accordingly.