AN INTERESTING CASE OF HYPOKALEMIC PARALYSIS

Hypokalemia is usually asymptomatic or may manifest as weakness, fatigue or abdominal distension. It may also present as cardiac arrhythmias, quadriparesis or respiratory paralysis. We report a 34 year old female who presented with acute onset progressive flaccid quadriparesis with respiratory paralysis. The laboratory tests revealed a severe hypokalemia with hyperchloremic metabolic acidosis and abnormally acidified urine. Here urine anion gap was positive, which in the presence of acidosis led to the diagnosis of distal renal tubular acidosis. The patient fully recovered after potassium and alkali replacement. Further investigations revealed Sjogren's syndrome as the underlying cause.