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Subsequent connective tissue disease serology confirmed previously undiagnosed Sjogren\u2019s syndrome. Successful recovery for this patient required multidisciplinary input from the intensive care, nephrology and neurology teams.<\/jats:p>","DOI":"10.1136\/bcr-2020-241300","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T12:01:00Z","timestamp":1620302460000},"page":"e241300","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Hypokalaemic paralysis as the initial clinical presentation of Sjogren\u2019s syndrome induced distal renal tubular acidosis"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3025-9470","authenticated-orcid":false,"given":"Jennifer M","family":"Kielty","sequence":"first","affiliation":[{"name":"Anaesthesiology and Intensive Care Medicine, Saint James's Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Ryan","sequence":"additional","affiliation":[{"name":"Medicine, Saint James's Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donal","family":"Sexton","sequence":"additional","affiliation":[{"name":"Nephrology, Saint James's Hospital, Dublin, Ireland"},{"name":"Trinity Health Kidney Centre, Trinity College Dublin School of Medicine, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvelynne P","family":"Kelly","sequence":"additional","affiliation":[{"name":"Intensive Care Medicine, Saint James's Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,5,6]]},"reference":[{"key":"2025082804215698000_14.5.e241300.1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-6757(92)90048-3"},{"key":"2025082804215698000_14.5.e241300.2","doi-asserted-by":"crossref","first-page":"2120.e1","DOI":"10.1016\/j.ajem.2019.158417","article-title":"Toluene toxicity presenting with hypokalemia, profound weakness and U waves in the electrocardiogram","volume":"37","author":"Carrizales-Sep\u00falveda","year":"2019","journal-title":"Am J Emerg Med"},{"key":"2025082804215698000_14.5.e241300.3","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.12.1275"},{"key":"2025082804215698000_14.5.e241300.4","doi-asserted-by":"crossref","first-page":"128","DOI":"10.4103\/0022-3859.194224","article-title":"Primary Sjogren's syndrome presenting as hypokalemic paralysis: a case series","volume":"63","author":"Goroshi","year":"2017","journal-title":"J Postgrad Med"},{"key":"2025082804215698000_14.5.e241300.5","first-page":"1","article-title":"Renal tubular acidosis and hypokalemic paralysis as a first presentation of primary Sj\u00f6gren's syndrome","volume":"2018","author":"Sedhain","year":"2018","journal-title":"Case Rep Nephrol"},{"key":"2025082804215698000_14.5.e241300.6","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1007\/s13760-020-01372-9","article-title":"Bilateral facial palsy as the first presentation of primary Sj\u00f6gren's syndrome: a case report and review of literature","volume":"120","author":"Alinezhad","year":"2020","journal-title":"Acta Neurol Belg"},{"key":"2025082804215698000_14.5.e241300.7","doi-asserted-by":"crossref","first-page":"205435811877453","DOI":"10.1177\/2054358118774536","article-title":"Complete hypokalemic quadriparesis as a first presentation of Sj\u00f6gren syndrome","volume":"5","author":"An","year":"2018","journal-title":"Can J Kidney Health Dis"},{"key":"2025082804215698000_14.5.e241300.8","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1053\/j.ackd.2018.05.003","article-title":"Hypokalemic distal renal tubular acidosis","volume":"25","author":"Vall\u00e9s","year":"2018","journal-title":"Adv Chronic Kidney Dis"},{"key":"2025082804215698000_14.5.e241300.9","unstructured":"Weber F , Lehmann-Horn F . 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