Primary Sjögren's syndrome associated with Gitelman's syndrome presenting with muscular paralysis.
A 38-year-old woman presented with muscle cramping of 4 extremities and paralysis for months. Laboratory results showed an elevated antinuclear antibody titer; antibodies to the ribonucleoprotein antigen Ro; hypokalemia; hypomagnesemia with hyperreninemia, but abnormally high urine potassium and magnesium levels and low urine calcium levels; and a blunted diuretic effect to thiazide, but not furosemide, which met the criteria for Gitelman's syndrome (GS) and led to the diagnosis of primary Sjögren's syndrome (pSS). She received medical treatment, including a potassium supplement and aldosterone antagonist. GS as a presentation of pSS has never been reported in the literature. The features of renal diseases related to SS are reviewed. SS is the underlying cause of GS, which may precede the onset of the well-known sicca complex.
Chen
Yen-Cheng
YC
Department of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei, Taiwan.
Yang
Wu-Chang
WC
Yang
An-Han
AH
Lin
Shih-Hua
SH
Li
Hsin-Yu
HY
Lin
Chih-Ching
CC
D000328:Adult; D000450:Aldosterone / Q000097:blood; D000471:Alkalosis / Q000097:blood / Q000209:etiology* / Q000652:urine; D000974:Antibodies, Antinuclear / Q000097:blood; D001324:Autoantigens; D001327:Autoimmune Diseases / Q000150:complications*; D001581:Benzothiadiazines; D002118:Calcium / Q000652:urine; D004231:Diuresis / Q000187:drug effects; D004232:Diuretics / Q000494:pharmacology; D005260:Female; D005665:Furosemide / Q000494:pharmacology; D006801:Humans; D007008:Hypokalemia / Q000209:etiology*; D008274:Magnesium / Q000097:blood / Q000652:urine; D009395:Nephritis, Interstitial / Q000209:etiology*; D010243:Paralysis / Q000097:blood / Q000209:etiology*; D011188:Potassium / Q000652:urine; D020733:RNA, Small Cytoplasmic; D012083:Renin / Q000097:blood; D012261:Ribonucleoproteins / Q000276:immunology; D012859:Sjogren's Syndrome / Q000150:complications* / Q000209:etiology; D049993:Sodium Chloride Symporter Inhibitors / Q000494:pharmacology; D013577:Syndrome; D000099207:SS-A Antigen
D000450:Aldosterone; D000974:Antibodies, Antinuclear; D001324:Autoantigens; D001581:Benzothiadiazines; D002118:Calcium; D004232:Diuretics; D005665:Furosemide; D008274:Magnesium; D011188:Potassium; D020733:RNA, Small Cytoplasmic; D012083:Renin; D012261:Ribonucleoproteins; D049993:Sodium Chloride Symporter Inhibitors; D000099207:SS-A Antigen; C116006:RO60 protein, human; C035356:SS-A antibodies