Hypokalaemia has a wide scale of causes. The most common ones include potassium loss from urinary tract, gastrointestinal system and loss through sweating. This is report is about a young 24-year-old Indian female who presented with sudden onset weakness of all four limbs which was found to be secondary to hypokalaemia. Refractory hypokalaemia and severe metabolic acidosis in this patient led to further work-up, which revealed positive Anti-SSA (anti-Sjögren’s-syndrome-related antigen A autoantibodies), AntiSSB Anti-Sjögren’s syndrome type B and Anti-snRNP (Small nuclear ribonucleoprotein), strongly suggestive of secondary Sjögren’s syndrome. Renal involvement with distal Renal Tubular Acidosis (RTA) causing hypokalaemia is seen in 10% of cases with Sjögren’s syndrome. Thus, this report highlights the unusual initial presentation of hypokalaemic paresis in a patient with Sjögren’s syndrome, and to emphasise that an autoimmune disorder should be considered in such presentations.

Sheehan's syndrome is a form of hypopituitarism caused by pituitary gland necrosis caused by hemorrhagic shock during pregnancy. It's a rare issue with a wide range of symptoms and a long time to diagnose. A 40-year-old female presented with a giddiness which was rotatory type followed by headache, vomiting associated with nausea, decreased appetite for one week. She has experienced excessive vaginal bleeding and secondary amenorrhea exists for 20 years. Patients diagnosed to have acute liver injury, hyponatremia, and acute gastritis. The thyroid profile showed hypothyroidism and the patient started on appropriate medication. Hypopituitarism due to Sheehan's disease was discovered after a thorough clinical examination, endocrine investigations, and a pituitary magnetic resonance scan. Following the start of hormone replacement therapy, she showed significant improvement. The current case demonstrates that undiagnosed Sheehan's syndrome is linked to long-term morbidity, and we want to emphasize the importance of a high index of suspicion for early diagnosis of the syndrome during routine clinical visits to avoid complications that can arise from delayed diagnosis.