Hypokalemic periodic paralysis in Sjogren's syndrome secondary to distal renal tubular acidosis.
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.
Department of Endocrinology and Metabolism, Dışkapı Yıldırım Beyazıt Education and Researching Hospital, 06110 Altındağ, Ankara, Turkey. drhakkiyilmaz@yahoo.com
Hakkı
H
Yılmaz
Mustafa
M
Kaya
Mustafa
M
Özbek
Kemal
K
ÜUreten
İ
İ
Safa Yıldırım
D000141:Acidosis, Renal Tubular / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D003131:Combined Modality Therapy; D004562:Electrocardiography; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D020514:Hypokalemic Periodic Paralysis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D012859:Sjogren's Syndrome / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome
D007166:Immunosuppressive Agents