Garza-Alpirez A, Arana-Guajardo A C, Esquivel-Valerio J A, Villarreal-Alarcón M A, Galarza-Delgado D A
Servicio de Reumatología, Departamento de Medicina Interna, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico.
Case Rep Rheumatol. 2017;2017:7509238. doi: 10.1155/2017/7509238. Epub 2017 Aug 1.
Tubulointerstitial nephritis (TIN) is the main renal involvement associated with primary Sjögren syndrome (pSS). TIN can manifest as distal renal tubular acidosis (RTA), nephrogenic diabetes insipidus, proximal tubular dysfunction, and others. We present a 31-year-old female with hypokalemic paralysis due to distal RTA (dRTA). She received symptomatic treatment and hydroxychloroquine with a good response. There is insufficient information on whether to perform a kidney biopsy in these patients or not. The evidence suggests that there is an inflammatory background and therefore a potential serious affection to these patients, such as hypokalemic paralysis. We found 52 cases of hypokalemic paralysis due to dRTA in pSS patients. The majority of those patients were treated only with symptomatic medication. Patients who received corticosteroids had stable evolution even though they did not have another symptomatology. With such heterogeneous information, prospective studies are needed to assess the value of adding corticosteroids as a standardized treatment of this manifestation.
肾小管间质性肾炎（TIN）是原发性干燥综合征（pSS）相关的主要肾脏受累情况。TIN可表现为远端肾小管酸中毒（RTA）、肾性尿崩症、近端肾小管功能障碍等。我们报告一例31岁因远端RTA（dRTA）导致低钾性麻痹的女性患者。她接受了对症治疗及羟氯喹，反应良好。关于这些患者是否进行肾活检的信息不足。有证据表明存在炎症背景，因此这些患者有发生如低钾性麻痹等潜在严重病变的可能。我们在pSS患者中发现了52例因dRTA导致低钾性麻痹的病例。这些患者大多数仅接受了对症治疗。接受糖皮质激素治疗的患者即使没有其他症状，病情也进展稳定。鉴于信息如此不统一，需要进行前瞻性研究来评估加用糖皮质激素作为这种表现的标准化治疗方法的价值。
