Abstract :
A 52 year old female patient presented to emergency casualty with Acute onset quadriparesis with respiratory muscle involvement in. During initial work up Serum electrolytes showed severe hypokalemia. Arterial blood gas showed normal anionic gap metabolic acidosis with positive urine anion gap and urine examination showed alkaline PH in the presence of systemic acidosis. All these findings suggest Distal Tubular Acidosis. Further evaluation revealed strongly positive Anti nuclear antibodies with SS-A also being positive suggesting Sjogren’s Syndrome.
Keywords :
Distal renal tubular acidosis, gbs, Hypokalemic paralysis, sjogren's syndrome.References :
- Gennari FJ. Hypokalemia. New England Journal of Medicine. 1998 Aug 13;339(7):451-8.
- Hypokalemia: a clinical update. Kardalas E, Paschou SA, Anagnostis P, Muscogiuri G, Siasos G, Vryonidou A. Endocr Connect. 2018;7:135–146.
- Kalita J, Nair PP, Kumar G, Misra UK. Renal tubular acidosis presenting as respiratory paralysis: Report of a case and review of literature. Neurology India. 2010 Jan 1;58(1):106.
- Distal renal tubular acidosis associated with Sjogren syndrome. Lim AK, Choi MJ. Intern Med J. 2013;43:1330–1334
- Treatment of distal (type 1) and proximal (type 2) renal tubular acidosis. [Aug;2018 ];
- Guerra-Hernández N, Matos-Martínez M, Ordaz-López KV, Camargo-Muñiz MD, Medeiros M, Escobar-Pérez L. Clinical and biochemical findings in Mexican patients with distal renal tubular acidosis. Rev Invest Clin. 2014 Sep 1;66(5):386-92.
- Groeneveld JH, Sijpkens YW, Lin SH, Davids MR, Halperin ML. An approach to the patient with severe hypokalaemia: the potassium quiz. QJM 98 305