Sjögren's syndrome is commonly presented with eye and mouth dryness caused by an autoimmune destruction of lacrimal and salivary glands. Kidney involvement is not common but may appear in patients with long standing disease. We present a patient with Sjögren's syndrome whose first manifestation of the disease was related to type 1 renal tubular acidosis (RTA) causing severe hypokalemia with lower limb paralysis. The uneven distribution of limb weakness necessitated the exclusion of cord compression.

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