Hypokalemic Paralysis Leading to Respiratory Failure: An Unusual Presentation of Sjogren’s Syndrome

Sjogren’s Syndrome (SS) is a chronic multisystemic autoimmune inflammatory disorder with predominant exocrine gland involvement resulting in dryness of the eyes and mouth. Among extra glandular manifestations, renal involvement is commonly seen, which can be in the form of Renal Tubular Acidosis (RTA). SS may at times present as mild hypokalaemia with distal RTA but severe hypokalemia resulting in respiratory failure is rare. Here we report a case of twenty-five-year-old female presenting in emergency room with flaccid quadriparesis and hypercapnic respiratory failure. Further evaluation revealed hypokalemia (Potassium (K+) 1.6mmol/L) with distal renal tubular acidosis along with a background of primary Sjogren’s Syndrome. We illustrate that the possibility of Sjogren’s Syndrome should be considered in a young female who present with rapidly progressive weakness, hypokalemia and distal renal tubular acidosis with respiratory failure.