Abstract

Primary sjogren’s syndrome (PSS) is a chronic inflammatory autoimmune disease which primarily affects exocrine glands mainly lachrymal and salivary. A case of primary Sjogren’s syndrome with episodic generalized weakness is illustrated. A 50-year old woman complained of dryness of mouth, cracks over tongue and dry eyes for the last 6 months. Dryness of mouth, loss of tears and crack tongue along with positive Schrimer’s test and high titers of ANA, Rheumatoid factor are enough to allow a convincing diagnosis of PSS. She developed brief period of generalized weakness off and on since one month. Neurological examination revealed Grade IV power with absence of wasting, normal reflexes and absence of sensory changes. Weakness was due to hypokalemia. Causes of hypokaemic palsy such as familial periodic palsy, Thyrotoxic periodic palsy were excluded and renal tubular acidosis (RTA) was found to be the cause of hypokalemia in this case.