In a case of a medical miracle, Isha Rajguru, a 16-year-old student got sudden weakness of her right hand and soon after a few hours right leg. The next day, she couldn’t walk and had to be carried out of bed by her parents. In two days even the neck went immovable. After admission to a nearby nursing home, she was diagnosed after investigations as a case of GBS, a serious nerve-inflammation disorder that is treated with immunoglobulin injections. By the time the family reached Global Hospital Parel, Mumbai, they were looking to admit her and give her immunoglobulin injections to treat GBS.
After she got admitted, a repeat Nerve conduction study was found to be normal and instead very low serum potassium (1.1, normal 3.5-5.5) was found as a cause of her muscular weakness. Before that, a detailed history had also revealed a complaint of dry mouth.
Nephrologists later found potassium was leaking from her kidneys due to a condition called type 1 Renal Tubular Acidosis (RTA), in her case the RTA was caused by Sjögren’s syndrome which is a rare disorder causing dry eyes and dry mouth due to an immunological attack causing inflammation in the salivary and lacrimal (tear) glands, and in addition, also cause RTA and potassium leak. Simple replacement of potassium led to her full recovery in 4-5 days. Expensive injections were avoided.
Dr Pankaj Agarwal, Sr Consultant- Neurology Head, Movement Disorders Clinic & In-charge, Deep Brain Stimulation (DBS), Global Hospital, Parel, Mumbai mentioned many medical conditions can mimic GBS, hence simple stepwise clinical approach, careful neurological assessment with a good medical history, proper interpretation of test results constitutes to the foundation of clinical medicines and can lead to the right diagnosis, even sometimes rare ones like in this case.
Mrs Rajguru, mother of the patient was overwhelmed mentioning that today her daughter who always aspired to be a model had lost complete hope in two bedridden days but with Dr Pankaj Agarwal’s treatment, Isha Rajguru was back on her feet in 4-5 days and saved costly injections, only because the doctor brought out a well-timed accurate diagnosis.
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