[Complications of distal tubular acidosis in primary Sjögren's syndrome].
Renal involvement in primary Sjögren's syndrome occurs in 10-60% of cases. Tubulointerstitial nephritis with distal renal tubular acidosis (DRTA) is the main type of involvement. It's generally asymptomatic and revealed by complications of DRTA. We report 4 cases of GJS complicated by nephrocalcinosis, tetapresic hypokaliemia and osteomalacia. In 2 cases, nephrocalcinosis was diagnosed simultaneously with the GJS. The 2 other cases were diagnosed 3 and 15 years after primary GJS. All patients were treated by coticosteroids at the dose of 0.5 mg/Kg/jour, alkaline solution, K Cl in 2 cases and vitamin D in 2 cases. After a mean follow up of 8.7 years, the renal function remain stable in the 3 cases of nephrocalcinosis and in a patient with osteomalacia, bone lesions progressed. In conclusion, DRTA must be detected by acidification tests in patients with primary Sjögren's syndrome because of their latency and to prevent severe complications.
Service de Médecine Interne A, Hôpital Charles Nicolle, TUNIS.
Soumaya
S
Béji
Hayet
H
Kaaroud
Fatma
F
Ben Moussa
L
L
Raies
H
H
Jebali
Fethi
F
Ben Hamida
Rym
R
Goucha
Fethi
F
El Younsi
Taieb
T
Ben Abdallah
Hédi
H
Ben Maiz
Adel
A
Kheder
D000141:Acidosis, Renal Tubular / Q000209:etiology*; D000328:Adult; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000209:etiology; D008875:Middle Aged; D009397:Nephrocalcinosis / Q000209:etiology; D010018:Osteomalacia / Q000209:etiology; D012859:Sjogren's Syndrome / Q000150:complications*