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Neglected sicca symptoms were retrospectively unearthed after a positive Schirmer\u2019s test. A diagnosis of Sj\u00f6gren\u2019s disease was considered after initial auto-immune screening. Subsequent definitive serology tested positive for anti-Sjogren\u2019s syndrome-associated antigens A (SS-A) and B (SS-B). This case is distinct in that the presenting symptom of Sj\u00f6gren\u2019s disease was acute areflexic quadriparesis. We hope to highlight Sj\u00f6gren\u2019s disease as a likely differential for seemingly idiopathic renal tubular acidosis even in the absence of overt sicca symptoms.<\/jats:p>","DOI":"10.1136\/bcr-2024-261480","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T17:45:54Z","timestamp":1739814354000},"page":"e261480","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Hypokalaemic quadriparesis due to distal renal tubular acidosis unmasking underlying Sj\u00f6gren\u2019s disease"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0427-8031","authenticated-orcid":false,"given":"Bryan","family":"Koithara","sequence":"first","affiliation":[{"name":"General Medicine, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Pune, Maharashtra, 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