BACKGROUNDMelioidosis is an emerging infectious disease in Brazil caused by exposure to water or soil contaminated by the bacteria Burkholderia pseudomallei. Its clinical presentation is diverse, ranging from uncomplicated soft tissue infections to severe pneumonia and sepsis. Musculoskeletal involvement (4 to 12%) is often associated with systemic manifestations, mainly affecting lower limbs.

BACKGROUNDSystemic lupus erythematosus (SLE) is a multisystemic autoimmune disease. About 40% of patients have gastrointestinal tract involvement. Protein-losing enteropathy (PPE) is a rare manifestation that in half of the cases manifests as diarrhea. Usually in young women and is characterized by the appearance of edema and hypoalbuminemia in the absence of proteinuria in the nephrotic range. Enteropathy may clinically manifest with edema or cavity effusions, depending on serum albumin levels. Other symptoms that may be present are: nausea, vomiting and abdominal pain.

BACKGROUNDSjögren's syndrome is a rare disease, of systemic presentation, which can occur in a primary or secondary form, with a prevalence between 0.05 to 0.4% of the general population. Its association with distal renal tubular acidosis (type I) is well documented in the literature, and may occur in 5 to 25% of patients with this diagnosis.