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- Title
PRIMARY SJÖGREN'S SYNDROME PRESENTING WITH RENAL TUBULAR ACIDOSIS- RELATED SEVERE HYPOKALEMIA: A CASE REPORT.
- Authors
UNAL, Hilmi Umut; TEKGÖZ, EMRE; KILIÇ, Ali; GOK, Mahmut; CETINKAYA, Hakkı; ÇINAR, Muhammet; YILMAZ, Mahmut Ilker; EYILETEN, Tayfun; VURAL, Abdulgaffar; OGUZ, Yusuf
- Abstract
INTRODUCTION: SS (Sjogren‟s syndrome) is an autoimmune lymphoproliferative disease of lacrimal and salivary glands. Mouth and eye dryness are clinical signs of the disease. Renal involvement varies from 2% to 65% percent. Renal involvement of Sjögren‟s syndrome may occur in the form of distal RTA and nephrogenic DI. RTAinduced hypokalemia may be asymptomatic, but sometimes it can be life-threatening. CASE: 39-year-old female patient with a history of recurrent nefrolithiasis with complaints of weakness in the legs, tingling and contraction referred to the emergency department. The results of the examination in the emergency room were as follows: serum K: 2.46 mmol / L, blood gases, pH: 7.26, HCO3: 12.2 mmol / L, Cl: 127 mmol / L. She was hospitalized for evaluation of hypokalemia and hyperchloremic metabolic acidosis. Patient‟s laboratory results were consistent with Type 1 (distal) Renal Tubular Acidosis. In the patient‟s systemic physical examination, stinging in both eyes and a dry mouth were present. ANA was positive. Anti SSA and anti SSB were both positive. Salivary gland biopsy revealed lymphocytic infiltration. Patient was considered as distal RTA due to primary Sjögren syndrome. DISCUSSION: RTA is a cause of normal anion gap acidosis. Nefrolithiasis often develops in these patients due to hypercalciuria and hypocitraturia. In middle-aged women, especially in patients with hypokalemia, a possible diagnosis of SS should not be forgotten. In some cases, hypokalemia may be the first symptom of the diasease. Sgögren syndrome may also occur after renal tubular acidosis.
- Publication
Balkan Military Medical Review, 2013, Vol 16, p216
- ISSN
1107-6275
- Publication type
Article