sodium-bicarbonate and Hypokalemic-Periodic-Paralysis

Topics: Acidosis, Renal Tubular; Adult; Autoantibodies; Calcium; Calcium-Regulating Hormones and Agents; Diagnosis, Differential; Electromyography; Female; Humans; Hypokalemic Periodic Paralysis; Male; Muscle Weakness; Potassium; Sjogren's Syndrome; Sodium Bicarbonate; Treatment Outcome

We report a rare case of a 38-year-old female who presented with sudden onset flaccid quadriplegia and respiratory arrest with no significant past clinical history. She was later found to have hypokalemia due to distal renal tubular acidosis and further diagnosed as case of Sjogrens Syndrome.

Topics: Acidosis, Renal Tubular; Administration, Intravenous; Adult; Antibodies, Antinuclear; Female; Glucocorticoids; Humans; Hypokalemic Periodic Paralysis; Potassium Chloride; Prednisolone; Quadriplegia; Salivary Glands; Sjogren's Syndrome; Sodium Bicarbonate; Treatment Outcome

A 43- year- old woman on treatment for primary hypothyroidism presented with 1- day progressive weakness of all her limbs and history of similar episodes in the past. Clinical examination revealed grade 2 hyporeflexive weakness. Investigations revealed features of hypokalemia, metabolic acidosis, alkaline urine, and a fractional bicarbonate excretion of 3.5%, consistent with distal renal tubular acidosis. Antithyroid peroxidase and antithroglobulin antibodies were positive, suggesting an autoimmune basis for the pathogenesis of the functional tubular defect. Bicarbonate therapy resulted in a sustained clinical recovery.

Topics: Acidosis, Renal Tubular; Adult; Female; Humans; Hypokalemic Periodic Paralysis; Hypothyroidism; Kidney; Sodium Bicarbonate; Symporters