A Case of Distal Renal Tubular Acidosis with Sjogren¡¯s Syndrome Presenting as Hypokalemic Paralysis
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¹ÚÇýÀ±(Park Hye-Yoon) - Kyungpook National University School of Medicine Department of Internal Medicine
¼Á¤¹ü(Seo Jung-Bum) - Kyungpook National University School of Medicine Department of Internal Medicine
ȲÀη®(Hwang In-Ryang) - Kyungpook National University School of Medicine Department of Internal Medicine
ÀÌÀ¯¸²(Lee Yu-Rim) - Kyungpook National University School of Medicine Department of Internal Medicine
±è°¡¿µ(Kim Ga-Young) - Catholic University of Daegu School of Medicine Department of Internal Medicine
³²¾ðÁ¤(Nam Eon-Jeong) - Kyungpook National University School of Medicine Department of Internal Medicine
±èÁ¤±¹(Kim Jung-Guk) - Kyungpook National University School of Medicine Department of Internal Medicine
Abstract
Distal renal tubular acidosis (RTA) caused by autoimmune nephritis occurs in up to 25% of patients with Sjogren¡¯s syndrome. However, patients with hypokalemic paralysis are sometimes overlooked, because most symptoms of autoimmune nephritis in Sjogren¡¯s syndrome are mild. We present a case of hypokalemic paralysis in a 54-year-old female who also had dry eyes and mouth, and Raynaud¡¯s phenomenon. Further evaluation, including autoantibody tests, revealed distal RTA with Sjogren¡¯s syndrome as the cause of hypokalemia. Distal RTA diagnosis was made based on normal anion gap hyperchloremic metabolic acidosis, alkaline urine with positive urine anion gap, high transtubular potassium concentration gradient (TTKG), positive anti-La antibody, and symptoms of sicca complex. The patient¡¯s symptoms resolved following treatment with intravenous and oral potassium, immunosuppressants, and steroids. This case illustrates that distal RTA and Sjogren¡¯s syndrome should be considered in cases of hypokalemic paralysis.
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Distal renal tubular acidosis, Hypokalemia, Sjogren¡¯s syndrome
KMID :
0980720140330010048
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