Hypokalaemic paralysis secondary to distal renal tubular acidosis as the presenting symptom of systemic lupus erythematosus

Gera C, Mohapatra D, Calton N
Correspondence: Dr Chanchal Gera, cgera@rediffmail.com

ABSTRACT
We report hypokalaemic quadriparesis presenting in a 43-year-old woman. Evaluation revealed hypokalaemic quadriparesis secondary to underlying distal renal tubular acidosis, also known as type 1 RTA. Four years after the diagnosis of RTA, the patient developed joint pain, and investigation revealed systemic lupus erythematosus with lupus nephritis. RTA is one of the very rare presentations of systemic lupus erythematosus. Thus, tubular dysfunction should be carefully assessed in patients with systemic lupus erythematosus. Similarly, patients with RTA should be evaluated for underlying lupus.Our patient was successfully treated with mycophenolate mofetil and steroids.

Keywords: hypokalemic paralysis, lupus nephritis, renal tubular dysfunction, systemic lupus erythematosus, type 1 RTA
Singapore Med J 2011; 52(1): e1-e3