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干燥综合征合并肾小管酸中毒所致低钾性周期性麻痹。

Sjögren syndrome presenting with hypopotassemic periodic paralysis due to renal tubular acidosis.

作者信息

Ataoglu Esra Hayriye, Demir Betul, Tuna Mazhar, Cavus Bilger, Cetin Faik, Temiz Levent Umit, Ozturk Savas, Yenigun Mustafa

机构信息

4 Clinic of Internal Medicine, Haseki Training and Research Hospital, Haseki Millet Caddesi, Aksaray, Turkey.

出版信息

Am J Case Rep. 2012;13:187-90. doi: 10.12659/AJCR.883326. Epub 2012 Aug 16.

Abstract

BACKGROUND

Sjögren syndrome (SS) is an autoimmune-lymphoproliferative disorder characterized by mononuclear cell infiltration of exocrine glands. Clinically, Sjögren syndrome (SS) has a wide spectrum, varying from autoimmune exocrinopathy to systemic involvement. There have been few cases reporting that primary SS developed with distal renal tubular acidosis clinically.

CASE REPORT

Here, we present a case with primary Sjögren syndrome accompanied by hypopotassemic paralysis due to renal tubular acidosis. Severe hypopotassemia, hyperchloremic metabolic acidosis, alkaline urine and disorder in urinary acidification test were observed in the biochemical examination of the 16-year-old female patient, who had applied to our clinic for extreme loss of muscle force. After the examinations it was determined that the patient had developed Type 1 RTA (distal RTA) due to primary Sjögren syndrome. Potassium and alkaline replacement was made and an immediate total recovery was achieved.

CONCLUSIONS

Hypopotassemic paralysis due to primary Sjögren syndrome is a rare but severe disorder that could lead to death if not detected early and cured appropriately. Thus, effective treatment should be immediately initiated in cases where severe hypopotassemia is accompanied by metabolic acidosis, and the cases should also be examined for extraglandular involvement of SS.

摘要

背景

干燥综合征(SS)是一种自身免疫性淋巴细胞增生性疾病,其特征为外分泌腺单核细胞浸润。临床上,干燥综合征(SS)范围广泛,从自身免疫性外分泌病到全身受累不等。临床报道原发性干燥综合征合并远端肾小管酸中毒的病例较少。

病例报告

在此,我们报告一例原发性干燥综合征伴肾小管酸中毒所致低钾性麻痹的病例。一名16岁女性患者因极度肌无力前来我院就诊,生化检查发现严重低钾血症、高氯性代谢性酸中毒、碱性尿及尿酸化试验异常。检查后确定该患者因原发性干燥综合征导致1型肾小管酸中毒(远端肾小管酸中毒)。给予补钾及补碱治疗后,患者立即完全康复。

结论

原发性干燥综合征所致低钾性麻痹是一种罕见但严重的疾病,若不及早发现并适当治疗可能导致死亡。因此,对于伴有严重低钾血症和代谢性酸中毒的病例应立即开始有效治疗,同时还应检查患者是否存在干燥综合征的腺外受累情况。

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