Respiratory Paralysis in Sjogren’s Syndrome

Primary Sjogren’s syndrome (pSS) a systemic autoimmune disease also known as sicca syndrome, primarily affects exocrine glands, particularly the salivary and lacrimal glands, and causes xerostomia and xerophthalmia. Renal involvement in cases of pSS is a rare occurrence. Patients with Sjogren’s syndrome presenting with severe hypokalemia or paralysis are uncommon. We present a case of a 45-year-old female presenting in our emergency department with hypokalemia-induced quadriparesis resulting from distal renal tubular acidosis due to Sjogren’s syndrome. It was revealed that symptoms of arthralgia and dry mouth had frequently been present for the past few years, with a persistent need for water intake. The patient was given symptomatic treatment during hospitalization and recovered successfully. The report emphasizes that although Sjogren’s syndrome is most often associated with chronic sicca symptoms, it may present for the first time with extraglandular manifestations, which may be life-threatening. Extraglandular forms of Sjogren’s disease can result in severe hypokalemia and paralysis of the limbs and respiratory muscles, which, if ignored, can be deadly for the patient. The course of action for such situations should be early identification and timely treatment because they are treatable and can give patients an asymptomatic and decent quality of life.