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Sjögren's syndrome presenting with hypokalemic paralysis
Ben Ghezala Hassen1, Snouda Salah2, Ben Chiekh Imen2, Ouali Jhen3
1Medical Director Physician Director, Teaching Department of Emergency and Intensive Care Medicine, Zaghouan Hospital, Zaghouan, Tunisia.
2Medical Director, Teaching Department of Emergency and Intensive Care Medicine, Zaghouan Hospital, Zaghouan, Tunisia.
3Medical Director, Department of Nephrology, Zaghouan Hospital, Zaghouan, Tunisia.

Article ID: 100012CRINTBH2015
doi:10.5348/crint-2015-12-CR-7

Address correspondence to:
Snouda Salah
Regional Hospital of Zaghouan, Avenue of Environment
Zaghouan 1100
Tunisia
Phone: +216 90269364
Fax: +216 72675772

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How to cite this article:
Hassen BG, Salah S, Imen BC, Jhen O. Sjögren's syndrome presenting with hypokalemic paralysis. Case Rep Int 2015;4:26–29.


Abstract
Introduction: Acute systemic weakness is a common reason for emergency department visit. Acute hypokalemic paralysis is one of its clinical presentation forms. It is a rare but treatable cause of acute weakness. We report a case that presented with hypokalemic paralysis in emergency room.
Case Report: We report a rare case of a 36-year-old female presented with sudden onset flaccid left hemiparesis with no significant past clinical history. Initially the patient was considered as an ischemic stroke, but she was later found to have hypokalemia due to distal renal tubular acidosis and further diagnosed as case of Sjögren's syndrome.
Conclusion: Acute flaccid neuromuscular weakness is a common presenting symptom in emergency room. Hypokalemia is an important differential diagnosis. The cause of hypokalemia should be sought. The diagnosis of distal renal tubular acidosis must be considered in patients presenting with hypokalemic paralysis and renal stones, and may be the first clue in the identification of an underlying autoimmune disorder, particularly Sjögren's syndrome.

Keywords: Hypokalemia paralysis, Neuromuscular weakness, Renal tubular acidosis, Sjögren's syndrome


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Author Contributions
Ben Ghezala Hassen – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Snouda Salah – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Ouali Jihen – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Ben chiekh Imen – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Ben Ghezala Hassen et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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