Hypokalemic periodic paralysis in Sjogren's syndrome secondary to distal renal tubular acidosis

Yilmaz H., Kaya M., Özbek M., Üreten K., Safa Yildirim S.

Rheumatology International, cilt.33, sa.7, ss.1879-1882, 2013 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 33 Sayı: 7
  • Basım Tarihi: 2013
  • Doi Numarası: 10.1007/s00296-011-2322-z
  • Dergi Adı: Rheumatology International
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1879-1882
  • Anahtar Kelimeler: Distal renal tubular acidosis, Hypokalemic paralysis, Primary sjogren syndrome
  • Yozgat Bozok Üniversitesi Adresli: Hayır

Özet

We report a 53-year-old Turkish female presented with progressive weakness and mild dyspnea. Laboratory results demonstrated severe hypokalemia with hyperchloremic metabolic acidosis. The urinary anion gap was positive in the presence of acidemia, thus she was diagnosed with hypokalemic paralysis from a severe distal renal tubular acidosis (RTA). Immunologic work-up showed a strongly positive ANA of 1:3,200 and positive antibodies to SSA and SSB. Schirmer's test was abnormal. Autoimmune and other tests revealed Sjögren syndrome as the underlying cause of the distal renal tubular acidosis. Renal involvement in Sjogren's syndrome (SS) is not uncommon and may precede sicca complaints. The pathology in most cases is a tubulointerstitial nephritis causing among other things, distal RTA, and, rarely, hypokalemic paralysis. Treatment consists of potassium repletion, alkali therapy, and corticosteroids. Primary SS could be a differential in women with acute weakness and hypokalemia. © 2011 Springer-Verlag.