Journal article
Unusual cause of hypokalemic paralysis in aged men : Sjogren syndrome
Southern medical journal (Birmingham, Ala.), Vol.98(12), pp.1212-1215
12/01/2005
DOI: 10.1097/01.smj.0000189906.32780.0c
PMID: 16440923
Abstract
Hypokalemic paralysis is a less recognized but reversible disorder in elderly patients. This report describes two elderly Chinese males (age 74 and 78 years) who had progressive muscle weakness and eventually paralysis. Physical examination showed symmetrical flaccid paralysis of extremities. Both had the major biochemical abnormality of profound hypokalemia (1.4 and 1.8 mmol/L) accompanied by high urine K+ excretion and hyperchloremic metabolic acidosis. A positive urine anion gap and alkaline urine pointed to the diagnosis of distal renal tubular acidosis. Large doses of potassium chloride supplementation were required to restore muscle strength. Pertinent investigations, including elevated titers of antinuclear antibody and rheumatoid factor, positive anti-Ro antibody, low serum C3 and C4 levels, and delayed saliva excretion on salivary scintigraphy suggested Sjögren syndrome. Despite the lack of sicca syndrome at the initial presentation, both had development of typical sicca syndrome and positive Schirmer test at the 5-month and 1-year follow-up, respectively. Potassium citrate supplement and prednisolone therapy completely corrected the hypokalemia and metabolic acidosis. Extraglandular involvement with distal renal tubular acidosis preceding the typical sicca syndrome may induce hypokalemic paralysis and unveil Sjögren syndrome in elderly males. Copyright © 2005 by The Southern Medical Association.
Details
- Title: Subtitle
- Unusual cause of hypokalemic paralysis in aged men : Sjogren syndrome
- Creators
- Chih-Jen Cheng - Tri-Service General HospitalJainn-Shiun Chiu - Tri-Service General HospitalChun-Chi Chen - Tri-Service General HospitalShih-Hua Lin - Tri-Service General Hospital
- Resource Type
- Journal article
- Publication Details
- Southern medical journal (Birmingham, Ala.), Vol.98(12), pp.1212-1215
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/01.smj.0000189906.32780.0c
- PMID
- 16440923
- ISSN
- 0038-4348
- eISSN
- 1541-8243
- Language
- English
- Date published
- 12/01/2005
- Academic Unit
- Nephrology; Internal Medicine
- Record Identifier
- 9984383310202771
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