A rare case of Sjogren’s syndrome presenting as acute quadriparesis

We report the case of a 23-year-old female who presented with multiple episodes of vomiting and loose stools for 2 days, followed by rapidly progressive quadriparesis for 1 day. Neurological examination revealed hyporeflexia and a power of 2/5 in all 4 limbs, with diminished deep tendon reflexes and a flexor plantar reflex. Laboratory investigations showed severe hypokalaemia with normal anion gap metabolic acidosis and renal loss of potassium secondary to distal renal tubular acidosis (RTA). Antinuclear antibody profiling tested positive for Sjogren syndrome-A/Ro-52 and Sjogren syndrome-B/La. The patient was diagnosed to have Sjogren’s syndrome as per the European League Against Rheumatism and the American College of Rheumatology criteria. This case highlights the importance of considering distal RTA secondary to Sjogren’s syndrome to hypokalaemia quadriparesis.