A case of Down syndrome with a posterior urethral valve

Type 1 renal tubular acidosis presenting as hypokalemic paralysis in Sjogren syndrome has been reported globally.[3] It may be the first presentation of Sjogren syndrome despite long duration of exocrine gland involvement or it may precede the sicca symptoms. Chen et al.[4] found that renal tubular acidosis was the initial manifestation of primary Sjogren’s syndrome in 75% out of a series of eight cases. The disease duration was shorter in patients with renal involvement than in those with normal acidification results.[5] Therefore, in patients presenting as hypokalemic paralysis a clinical suspicion can unmask a sub clinical Sjogren syndrome.