Hypokalemic paralysis and osteomalacia secondary to renal tubular acidosis in a case with primary Sjögren's syndrome

Modern Rheumatology
Masanori KawashimaHirofumi Makino

Abstract

A 39-year-old Japanese woman was admitted to our hospital for severe weakness owing to potassium deficiency caused by type 1 renal tubular acidosis (RTA1). Sicca complex, serological tests, and lip biopsy revealed that she had Sjögren's syndrome (SS). Acidosis was corrected by alkali supplement treatment. She also had an impaired renal function with proteinuria, and high absorbance on Ga scintigram was recognized in both kidneys. She was taking warfarin potassium after aortic valve substitution due to aortic regurgitation, therefore renal biopsy was not performed. Prednisone (20 mg/day) was administered for renal inflammation. One month later, she suffered severe chest wall pains with some local tender points over the costae of both sides, which was presumed to be due to pseudo-fractures based on osteomalacia. Hypokalemic paralysis and osteomalacia should be taken into consideration in the diagnosis of SS with RTA1.

References

Apr 1, 1970·The American Journal of Medicine·R ShiojiY Sasaki
Dec 1, 1995·Scandinavian Journal of Urology and Nephrology·P ErikssonF Lindström
May 29, 2000·QJM : Monthly Journal of the Association of Physicians·K AasarødS Jørstad
May 15, 2002·Annals of the Rheumatic Diseases·C VitaliUNKNOWN European Study Group on Classification Criteria for Sjögren's Syndrome

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Citations

Oct 23, 2012·Indian Journal of Endocrinology and Metabolism·Deepak KhandelwalAriachery C Ammini
Aug 3, 2013·Renal Failure·Hikmet TekçeSerkan Öztürk
Aug 25, 2017·Case Reports in Rheumatology·A Garza-AlpirezD A Galarza-Delgado
Jan 24, 2014·South Asian Journal of Cancer·Gajanan S GaudeJyothi Karanji

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