Acute Hypokalemic Paralysis Secondary to Distal Renal Tubular Acidosis Presenting as Guillain Barre Syndrome

A 52 year old female patient presented to emergency casualty with Acute onset quadriparesis with respiratory muscle involvement in. During initial work up Serum electrolytes showed severe hypokalemia. Arterial blood gas showed normal anionic gap metabolic acidosis with positive urine anion gap and urine examination showed alkaline PH in the presence of systemic acidosis. All these findings suggest Distal Tubular Acidosis. Further evaluation revealed strongly positive Anti nuclear antibodies with SS-A also being positive suggesting Sjogren’s Syndrome.