Renal Tubular Acidosis Causing Acute Hypokalemic Paralysis in Systemic Lupus Erythematosus: Sjogren’s Syndrome Overlap

Acute hypokalemic paralysis (AHP) is a reversible medical emergency either caused by excessive loss of potassium ions (K+) or increased intracellular shift of K+. Distal renal tubular acidosis (RTA) is an important differential to rule out in patients presenting with AHP. RTA is a constellation of disorders that have been associated with renal damage caused by autoimmune conditions such as systemic lupus erythematosus (SLE) and Sjögren's syndrome (SS). Here we present a case of a 44-year-old woman with a history of SLE in the absence of kidney disease who presented with AHP and was found to have distal RTA and antibodies positive for SS concerning tubulointerstitial nephritis in the setting of SS/SLE overlap syndrome.