Renal Tubular Acidosis and Hypokalemic Paralysis as a First Presentation of Primary Sjögren's Syndrome

Sjögren's syndrome is an autoimmune disease with multisystem involvement and varying clinical presentation. We report the clinical course and outcome of a case who presented with repeated episodes of hypokalemia mimicking hypokalemic periodic paralysis and metabolic acidosis, which was later di...

Descripción completa

Detalles Bibliográficos
Autores principales: Sedhain, Arun, Acharya, Kiran, Sharma, Alok, Khan, Amir, Adhikari, Shital
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206514/
https://www.ncbi.nlm.nih.gov/pubmed/30410805
http://dx.doi.org/10.1155/2018/9847826
_version_ 1783366365003907072
author Sedhain, Arun
Acharya, Kiran
Sharma, Alok
Khan, Amir
Adhikari, Shital
author_facet Sedhain, Arun
Acharya, Kiran
Sharma, Alok
Khan, Amir
Adhikari, Shital
author_sort Sedhain, Arun
collection PubMed
description Sjögren's syndrome is an autoimmune disease with multisystem involvement and varying clinical presentation. We report the clinical course and outcome of a case who presented with repeated episodes of hypokalemia mimicking hypokalemic periodic paralysis and metabolic acidosis, which was later diagnosed as distal renal tubular acidosis secondary to primary Sjögren's syndrome. A 50-year-old lady, who was previously diagnosed as hypokalemic periodic paralysis, presented with generalized weakness and fatigue. She was found to have severe hypokalemia with normal anion-gap metabolic acidosis consistent with distal renal tubular acidosis. Subsequent evaluation revealed Sjögren's syndrome as the cause of her problems. Kidney biopsy done to evaluate significant proteinuria revealed nonproliferative morphology with patchy acute tubular injury and significant chronic interstitial nephritis. The patient responded well to potassium supplementation and oral prednisolone. Presentation of this case highlights the necessity of close vigilance while managing a case of repeated hypokalemia, which could be one of the rare clinical manifestations of Sjögren's syndrome.
format Online
Article
Text
id pubmed-6206514
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Hindawi
record_format MEDLINE/PubMed
spelling pubmed-62065142018-11-08 Renal Tubular Acidosis and Hypokalemic Paralysis as a First Presentation of Primary Sjögren's Syndrome Sedhain, Arun Acharya, Kiran Sharma, Alok Khan, Amir Adhikari, Shital Case Rep Nephrol Case Report Sjögren's syndrome is an autoimmune disease with multisystem involvement and varying clinical presentation. We report the clinical course and outcome of a case who presented with repeated episodes of hypokalemia mimicking hypokalemic periodic paralysis and metabolic acidosis, which was later diagnosed as distal renal tubular acidosis secondary to primary Sjögren's syndrome. A 50-year-old lady, who was previously diagnosed as hypokalemic periodic paralysis, presented with generalized weakness and fatigue. She was found to have severe hypokalemia with normal anion-gap metabolic acidosis consistent with distal renal tubular acidosis. Subsequent evaluation revealed Sjögren's syndrome as the cause of her problems. Kidney biopsy done to evaluate significant proteinuria revealed nonproliferative morphology with patchy acute tubular injury and significant chronic interstitial nephritis. The patient responded well to potassium supplementation and oral prednisolone. Presentation of this case highlights the necessity of close vigilance while managing a case of repeated hypokalemia, which could be one of the rare clinical manifestations of Sjögren's syndrome. Hindawi 2018-10-16 /pmc/articles/PMC6206514/ /pubmed/30410805 http://dx.doi.org/10.1155/2018/9847826 Text en Copyright © 2018 Arun Sedhain et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Sedhain, Arun
Acharya, Kiran
Sharma, Alok
Khan, Amir
Adhikari, Shital
Renal Tubular Acidosis and Hypokalemic Paralysis as a First Presentation of Primary Sjögren's Syndrome
title Renal Tubular Acidosis and Hypokalemic Paralysis as a First Presentation of Primary Sjögren's Syndrome
title_full Renal Tubular Acidosis and Hypokalemic Paralysis as a First Presentation of Primary Sjögren's Syndrome
title_fullStr Renal Tubular Acidosis and Hypokalemic Paralysis as a First Presentation of Primary Sjögren's Syndrome
title_full_unstemmed Renal Tubular Acidosis and Hypokalemic Paralysis as a First Presentation of Primary Sjögren's Syndrome
title_short Renal Tubular Acidosis and Hypokalemic Paralysis as a First Presentation of Primary Sjögren's Syndrome
title_sort renal tubular acidosis and hypokalemic paralysis as a first presentation of primary sjögren's syndrome
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206514/
https://www.ncbi.nlm.nih.gov/pubmed/30410805
http://dx.doi.org/10.1155/2018/9847826
work_keys_str_mv AT sedhainarun renaltubularacidosisandhypokalemicparalysisasafirstpresentationofprimarysjogrenssyndrome
AT acharyakiran renaltubularacidosisandhypokalemicparalysisasafirstpresentationofprimarysjogrenssyndrome
AT sharmaalok renaltubularacidosisandhypokalemicparalysisasafirstpresentationofprimarysjogrenssyndrome
AT khanamir renaltubularacidosisandhypokalemicparalysisasafirstpresentationofprimarysjogrenssyndrome
AT adhikarishital renaltubularacidosisandhypokalemicparalysisasafirstpresentationofprimarysjogrenssyndrome