원위부 신세뇨관 산증에 의한 저칼륨성 주기성 마비로 발현한 Sjogren 증후군 = A Case of Sjogren`s Syndrome Presented as Hypokalemic Periodic Paralysis due to Distal Renal Tubular Acidosis

다국어 초록 (Multilingual Abstract)

Distal renal tubular acidosis(dRTA) can be associated with some autoimmune diseases such as systemic lupus erythematosus, Sjogren`s syndrome, and rheumatoid arthritis. Although hypokalemia in Sjogren`s syndrome is a frequent complication, severe symptomatic hypokalemia has been reported only in few cases. Recently we experienced a case of Sjogren`s syndrome diagnosed after the discovery of distal renal tubular acidosis with severe hypokalemia manifestating periodic weakness, myalgia in lower extremities, nausea, vomiting, and flaccid paralysis. She complained continuous sensation of dryness of her eyes and mouth. After the Schirmer`s test, salivary scan, serologic tests, and lip biopsy, Sjogren`s syndrome was confirmed. Intravenous and oral potassium replacement was started immediately, oral sodium bicarbonate later. Marked improvement in periodic paralysis was noted within a few hours and she was fully regained her muscle strength within 48 hours. She discharged with oral sodium bicarbonate and artificial tears. With this treatment blood pH and potassium were kept in the normal range during follow up visits.