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A Case of Distal Renal Tubular Acidosis with Sjögren’s Syndrome Presenting as Hypokalemic Paralysis

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Author(s)
Hye Yoon ParkJung Bum SeoIn Ryang HwangYu Rim LeeGa Young KimEon Jeong NamJung Guk Kim
Journal Title
Keimyung Medical Journal
Issued Date
2014
Volume
33
Issue
1
Keyword
Sjögren's syndrome
Abstract
Distal renal tubular acidosis (RTA) caused by autoimmune nephritis occurs in up to 25% of
patients with Sjögren’s syndrome. However, patients with hypokalemic paralysis are sometimes
overlooked, because most symptoms of autoimmune nephritis in Sjögren’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 Sjögren’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 Sjögren’s syndrome should be considered in cases of hypokalemic paralysis.
Alternative Title
A Case of Distal
Renal Tubular Acidosis with Sjögren’s Syndrome Presenting as Hypokalemic Paralysis
Publisher
Keimyung University School of Medicine
Citation
Hye Yoon Park et al. (2014). A Case of Distal Renal Tubular Acidosis with Sjögren’s Syndrome Presenting as Hypokalemic Paralysis. Keimyung Medical Journal, 33(1), 48–52.
Type
Article
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/15630
Appears in Collections:
2. Keimyung Medical Journal (계명의대 학술지) > 2014
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