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Hypokalemic Paralysis and Hypocalcemic Tetany: Paradoxical Duality in a Case of Sjogren's Syndrome

A 26-year-old female was hospitalized with acute lower motor neuron quadriplegia. Laboratory tests pointed to the presence of distal renal tubular acidosis, which was characterized by hyperchloremic metabolic acidosis, severe hypokalemia, alkaline urine, and a positive urinary anion gap. She also ha...

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Autores principales: Kadam, Abhinav, Acharya, Sourya, Kumar, Sunil, Shukla, Samarth, Sawant, Rucha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10695414/
http://dx.doi.org/10.7759/cureus.48268
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author Kadam, Abhinav
Acharya, Sourya
Kumar, Sunil
Shukla, Samarth
Sawant, Rucha
author_facet Kadam, Abhinav
Acharya, Sourya
Kumar, Sunil
Shukla, Samarth
Sawant, Rucha
author_sort Kadam, Abhinav
collection PubMed
description A 26-year-old female was hospitalized with acute lower motor neuron quadriplegia. Laboratory tests pointed to the presence of distal renal tubular acidosis, which was characterized by hyperchloremic metabolic acidosis, severe hypokalemia, alkaline urine, and a positive urinary anion gap. She also had aminoaciduria, hyperphosphaturia, hypophosphatemia, and normoglycemic glycosuria, all of which are indicative of dysfunction of proximal tubules. Further investigation confirmed Sjogren's syndrome. Strangely, our patient also experienced carpopedal spasms and had low calcium and magnesium levels. As the hypokalemia, hypocalcemia, and acidosis were corrected, the quadriplegia and carpopedal spasm improved. By the time of discharge, proximal tubular abnormalities were rectified (with the exception of albuminuria). One well-known renal symptom of Sjogren's syndrome is distal tubular acidosis. The brief proximal tubular dysfunction and distal tubular acidosis in Sjogren’s syndrome is rare. This case report highlights a rare renal complication of Sjogren’s syndrome.
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spelling pubmed-106954142023-12-05 Hypokalemic Paralysis and Hypocalcemic Tetany: Paradoxical Duality in a Case of Sjogren's Syndrome Kadam, Abhinav Acharya, Sourya Kumar, Sunil Shukla, Samarth Sawant, Rucha Cureus Internal Medicine A 26-year-old female was hospitalized with acute lower motor neuron quadriplegia. Laboratory tests pointed to the presence of distal renal tubular acidosis, which was characterized by hyperchloremic metabolic acidosis, severe hypokalemia, alkaline urine, and a positive urinary anion gap. She also had aminoaciduria, hyperphosphaturia, hypophosphatemia, and normoglycemic glycosuria, all of which are indicative of dysfunction of proximal tubules. Further investigation confirmed Sjogren's syndrome. Strangely, our patient also experienced carpopedal spasms and had low calcium and magnesium levels. As the hypokalemia, hypocalcemia, and acidosis were corrected, the quadriplegia and carpopedal spasm improved. By the time of discharge, proximal tubular abnormalities were rectified (with the exception of albuminuria). One well-known renal symptom of Sjogren's syndrome is distal tubular acidosis. The brief proximal tubular dysfunction and distal tubular acidosis in Sjogren’s syndrome is rare. This case report highlights a rare renal complication of Sjogren’s syndrome. Cureus 2023-11-04 /pmc/articles/PMC10695414/ http://dx.doi.org/10.7759/cureus.48268 Text en Copyright © 2023, Kadam et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Kadam, Abhinav
Acharya, Sourya
Kumar, Sunil
Shukla, Samarth
Sawant, Rucha
Hypokalemic Paralysis and Hypocalcemic Tetany: Paradoxical Duality in a Case of Sjogren's Syndrome
title Hypokalemic Paralysis and Hypocalcemic Tetany: Paradoxical Duality in a Case of Sjogren's Syndrome
title_full Hypokalemic Paralysis and Hypocalcemic Tetany: Paradoxical Duality in a Case of Sjogren's Syndrome
title_fullStr Hypokalemic Paralysis and Hypocalcemic Tetany: Paradoxical Duality in a Case of Sjogren's Syndrome
title_full_unstemmed Hypokalemic Paralysis and Hypocalcemic Tetany: Paradoxical Duality in a Case of Sjogren's Syndrome
title_short Hypokalemic Paralysis and Hypocalcemic Tetany: Paradoxical Duality in a Case of Sjogren's Syndrome
title_sort hypokalemic paralysis and hypocalcemic tetany: paradoxical duality in a case of sjogren's syndrome
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10695414/
http://dx.doi.org/10.7759/cureus.48268
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