RESUMO
BACKGROUND: Sjögren's syndrome (SS) is autoimmune disorder charaterized by exocrine glandular involvement and extra-glandular manifestations. Associations between hypokalemic paralysis and SS have not been emphasized enough. Present study evaluates hypokalemic paralysis as presenting feature in PSS. METHODS: A retrospective cross-sectional study from 2015 to 2020 was conducted to evaluate the clinical phenotype of primary Sjögren's syndrome (PSS) who presented to us with hypokalemic paralysis. RESULTS: Data of 13 patients were evaluated. All were female patients and mean age was 38 years. 61.5% (n= 8) had more than one episode of hypokalemic paralysis; 61.5% (n= 8) patients had oral dryness and 69% (n= 9) had dryness of eyes. 23% (n= 3) patients had inflammatory arthritis and 1 patient had Raynaud's phenomenon, myopathy respectively. 1 patient had chronic constipation and hypothyroidism was present in 61.5% (n= 8) patients. Other co-morbidity included hypertension, renal calculi and situs inversus present in 15%, 15% and 7% respectively. The mean ESR at presentation was 64 mm/hr; average serum potassium level was 2.04meq/dl and distal renal tubular acidosis was present in all patients. Paralysis was completely recovered in all patients after supplementation with potassium. CONCLUSION: The renal involvement in PSS can uncommonly present as hypokalemic paralysis in the absence of significant sicca symptoms or may precede sicca symptoms. A high index of suspicion for PSS should be kept in all patients with hypokalemic paralysis. This phenotype may represent a distinct subset. Serum electrolytes should be regularly monitored in all patients with SS.