Recurrenthypokalemic Weakness Secondary to Sjogren’s Syndrome: A dRTA Effect

Abstract

Renal involvement is observed in approximately 5% of patients with Sjögren’s syndrome (SS), with tubulointerstitial nephritis and membranoproliferative glomerulonephritis being the predominant lesions1. We describe the case of a 50-year-old female who presented with lower limb weakness. The comprehensive evaluation revealed hypokalemic paralysis and subsequent investigations confirmed a diagnosis of type 1 distal renal tubular acidosis (dRTA) secondary to SS. The patient was managed with symptomatic treatment, including intravenous potassium chloride and sodium bicarbonate to correct hypokalemia and acidosis, alongside corticosteroids and hydroxychloroquine for immunomodulation of SS. Clinical improvement was observed with resolution of acidosis and stabilization of serum potassium levels. This case underscores the importance of considering dRTA in SS patients presenting with neuromuscular weakness and highlights the effective role of combined electrolyte correction and immunosuppressive therapy in such cases. The patient magically improved with the correction of acidosis and hypokalemia.