Hypokalemic quadriparesis associated with renal tubular acidosis in a patient with Sjögrens syndrome

Aygen, Bilge; Dursun, Fatma; Doğukan, Ayhan; Ozercan, I H; Çeli̇ker, Hüseyin

doi:10.5414/cnp69306

Cited by 17 publications

(18 citation statements)

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“…Distal RTA occurs in up to 25% of patients with Sjögren's syndrome (12). A few case reports of Sjögren's syndrome associated with hypokalemia or hypokalemic periodic paralysis and distal RTA have been reported (13)(14)(15)(16)(17). However, the mechanism by which Sjögren's syndrome leads to distal RTA still remains to be completely elucidated.…”

Section: Discussionmentioning

confidence: 99%

Decreased Renal Expression of H<sup>+</sup>-ATPase and Pendrin in a Patient with Distal Renal Tubular Acidosis Associated with Sjögren's Syndrome

Kim

Bae

et al. 2015

Intern. Med.

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A 31-year-old woman with no significant past medical or family history was admitted with complaints of general weakness. Laboratory tests revealed: serum potassium 3.0 mEq/L, arterial blood pH 7.28, serum bicarbonate 17.8 mEq/L and urinary pH 7.0. Double-labeling confocal fluorescence microscopy using H + -ATPase and pendrin antibodies demonstrated a decreased expression of these proteins in the patient's renal collecting duct compared to normal controls. Anti-Sjögren's-syndrome-related antigen A (Anti-Ro/SS-A) and anti-Sjögren's syndrome type B (anti-La/SS-B) antibodies were strongly positive with very high titers, consistent with Sjögren's syndrome. We present a case of distal renal tubular acidosis-associated Sjögren's syndrome with a defect in H + -ATPase and pendrin in the renal collecting duct.

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Section: Discussionmentioning

confidence: 99%

Decreased Renal Expression of H<sup>+</sup>-ATPase and Pendrin in a Patient with Distal Renal Tubular Acidosis Associated with Sjögren's Syndrome

Kim

Bae

et al. 2015

Intern. Med.

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“…[2][3][4][5][6][7][8][9][10] Hypokalemic paralysis due to type 1 renal tubular acidosis in SS has been reported worldwide. [11][12][13][14][15][16][17][18][19] It may precede the sicca symptoms or it may be the first presentation of SS despite long duration of exocrine gland involvement. [11][12][13][14][15][16][17][18][19] The overall incidence of type 1 RTA in SS varies from 5-33 %.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14][15][16][17][18][19] It may precede the sicca symptoms or it may be the first presentation of SS despite long duration of exocrine gland involvement. [11][12][13][14][15][16][17][18][19] The overall incidence of type 1 RTA in SS varies from 5-33 %. [20,21] However the defect in urinary acidification has been found to up to 50% in a series of twelve cases by Talal et al and up to 67% in a series of twenty seven cases by Eriksson et aland interestingly renal tubular acidosis was the initial manifestation of primary SS in 75 % in a series of 8 cases by Chen et al [6,22,23] The overall prevalence of SS in India is very less as compared to western countries.…”

Section: Discussionmentioning

confidence: 99%

Hypokalemic Quadriparesis in a female-The marker for Sjogren′s syndrome

Naik¹,

Najar²,

Bhat³

et al. 2013

Ann Trop Med Public Health

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“…5 Several reports were about quadriparesis related to distal RTA. 6 There is a strong correlation between the severity and development rate of hypokalemia and the neurological symptoms. 3,7 It is even possible that type 1 RTA may present with more severe neurological symptoms such as respiratory paralysis.…”

Section: Discussionmentioning

confidence: 99%

A distal (type 1) renal tubular acidosis case that mimic coronary ischemia

2013

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Introduction: Type 1 (distal) renal tubular acidosis (RTA) is a rare clinical condition characterized with defect of urinary acidification in distal tubulus. If diagnosis delays, RTA may cause metabolic and clinical complications and comorbidities. We describe here a type 1 distal RTA case with symptoms mimicking coronary ischemia. Case report: A 46-year-old woman admitted with complaints of chest pain, palpitation, walking disability, fatigue and nausea. On physical examination muscles were weaken 3/5 in four extremities. An electrocardiogram revealed supraventricular tachycardia and ST depression on precordial V2-6 derivations. An acute coronary syndrome diagnosis made based on anginal symptoms, supraventricular tachycardia, ST depression on V2-6 derivations and elevated cardiac enzymes. Urgent coronary angiography was normal except a 30% narrowing in LAD. She had recurrent nephrolithiasis and had operated because of hydronephrosis. She had two episodes of fatigue and walking disability previously. Hyperchloremic metabolic acidosis with normal anion gap determined in blood gas analyze. Patient diagnosed with type I RTA with the signs and symptoms of recurrent nephrolithiasis, fatigue, severe hypokalemia (1.8 mmol/L), hyperchloremic metabolic acidosis with normal anionic gap, alkaline urine (pH 8) and positive urinary anionic gap (13.7 mmol/L). Sodium bicarbonate infusion and potassium replacement therapy administered. Clinical and laboratory signs of the patient dissolved during treatment. Conclusion: Type 1 RTA should be considered in acidotic patients admitted with hypokalemia and coronary symptoms. Urinary and blood gas analyses should be done beside cardiac tests initially. Therefore, a precise diagnosis may be possible without the possible complications of unnecessary coronary interventions.

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Hypokalemic quadriparesis associated with renal tubular acidosis in a patient with Sjögrens syndrome

Cited by 17 publications

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Decreased Renal Expression of H<sup>+</sup>-ATPase and Pendrin in a Patient with Distal Renal Tubular Acidosis Associated with Sjögren's Syndrome

Decreased Renal Expression of H<sup>+</sup>-ATPase and Pendrin in a Patient with Distal Renal Tubular Acidosis Associated with Sjögren's Syndrome

Hypokalemic Quadriparesis in a female-The marker for Sjogren′s syndrome

A distal (type 1) renal tubular acidosis case that mimic coronary ischemia

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Hypokalemic quadriparesis associated with renal tubular acidosis in a patient with Sjögrens syndrome

Cited by 17 publications

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Decreased Renal Expression of H<sup>+</sup>-ATPase and Pendrin in a Patient with Distal Renal Tubular Acidosis Associated with Sj&ouml;gren's Syndrome

Decreased Renal Expression of H<sup>+</sup>-ATPase and Pendrin in a Patient with Distal Renal Tubular Acidosis Associated with Sj&ouml;gren's Syndrome

Hypokalemic Quadriparesis in a female-The marker for Sjogren′s syndrome

A distal (type 1) renal tubular acidosis case that mimic coronary ischemia

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Resources

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Hypokalemic quadriparesis associated with renal tubular acidosis in a patient with Sjögrens syndrome

Decreased Renal Expression of H<sup>+</sup>-ATPase and Pendrin in a Patient with Distal Renal Tubular Acidosis Associated with Sjögren's Syndrome

Decreased Renal Expression of H<sup>+</sup>-ATPase and Pendrin in a Patient with Distal Renal Tubular Acidosis Associated with Sjögren's Syndrome