{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T10:56:23Z","timestamp":1766400983981,"version":"3.41.2"},"reference-count":15,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T00:00:00Z","timestamp":1722384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec><jats:title>Key Clinical Message<\/jats:title><jats:p>In managing Sjogren's syndrome, a thorough patient history, proper lab tests, and imaging are crucial. Clinicians should prioritize checking electrolyte levels in cases of muscle weakness, as early detection of hypokalemia can prevent severe complications. Proactive monitoring can avert renal tubular acidosis and improve patient outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Distal renal tubular acidosis (dRTA) occurs in approximately one\u2010third of patients with Sjogren's syndrome, a systemic autoimmune disorder characterized by lymphocytic infiltration of exocrine glands, leading to dryness of mucous membranes. Hypokalemic paralysis, a well\u2010documented but rare complication of dRTA, typically manifests as symmetric proximal muscle weakness of the extremities. We present the case of a 38\u2010year\u2010old woman with a history of Sjogren's syndrome diagnosed 3\u2009years prior, who ceased her medication without medical supervision. She presented with quadriplegia, initially beginning unilaterally. This particular presentation is seldom documented in the literature. Laboratory investigations revealed hypokalemia and normal anion gap metabolic acidosis, consistent with dRTA\u2010induced hypokalemic paralysis. Intravenous potassium chloride was administered, resulting in complete recovery of muscle strength. Hypokalemic paralysis associated with dRTA is typically reversible; however, delays in diagnosis and treatment can lead to life\u2010threatening complications such as respiratory failure and arrhythmias. Therefore, clinicians should maintain a high index of suspicion for this condition in patients presenting with muscle weakness. Prompt and precise history takingand screening, and initiating appropriate management to prevent adverse outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccr3.9227","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T04:50:58Z","timestamp":1722487858000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Hypokalemic quadriplegia in Sjogren's syndrome: A case report"],"prefix":"10.1002","volume":"12","author":[{"given":"Mahsa","family":"Mehdipour\u00a0Dalivand","sequence":"first","affiliation":[{"name":"Guilan Rheumatology Research Center, Department of Rheumatology, Razi Hospital, School of Medicine Guilan University of Medical Sciences  Rasht Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rezvan","family":"Abdolazimi","sequence":"additional","affiliation":[{"name":"Rheumatology Research Center Tehran University of Medical Sciences  Rasht Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Majid","family":"Alikhani","sequence":"additional","affiliation":[{"name":"Rheumatology Research Center Tehran University of Medical Sciences  Rasht Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,31]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.47"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kev223"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kev200"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.75.882.193"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-6757(92)90048-3"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)66990-5"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2006.05.003"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2015.174"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2004.07.049"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajprenal.1997.273.5.F796"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/0022-3859.194224"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.5811\/cpcem.2019.11.44966"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2022.04.042"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.smj.0000189906.32780.0c"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.5414\/CNCS110994"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.9227","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,14]],"date-time":"2024-09-14T04:27:47Z","timestamp":1726288067000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.9227"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,31]]},"references-count":15,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1002\/ccr3.9227"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.9227","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"type":"print","value":"2050-0904"},{"type":"electronic","value":"2050-0904"}],"subject":[],"published":{"date-parts":[[2024,7,31]]},"assertion":[{"value":"2024-03-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e9227"}}