Primary Sjögren's disease and its complications presenting with progressive paralysis.
A 24-year-old female presented with generalised weakness, lethargy and aches in legs. She was subsequently found to be markedly hypokalaemic and have a metabolic acidosis. A diagnosis of distal renal tubular acidosis (RTA) was made. In addition to this failure to alkalinise her urine, she was unable to concentrate it and so a diagnosis of nephrogenic diabetes insipidus was reached. Further questioning revealed previous investigation of a connective tissue disorder thought to be primary Sjögren's syndrome. RTA is a recognised but rare complication of Sjögren's syndrome. Urinary alkalinisation using potassium bicarbonate was instituted; the patient responded well to treatment and is having outpatient follow-up.
Critical Care Department, Heartlands Hospital, Birmingham, UK. mattjulian@doctors.org.uk
Matthew
M
Julian
Trishna
T
Chakravorty
Philip
P
Dyer
D000141:Acidosis, Renal Tubular / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D010243:Paralysis / Q000209:etiology*; D012859:Sjogren's Syndrome / Q000150:complications*; D055815:Young Adult