Nakhoul F, Plavnic Y, Lichtig H, Better O S
Department of Nephrology, Rambam Medical Center, Haifa, Israel.
Isr J Med Sci. 1993 May;29(5):300-3.
We describe a patient who presented dramatically with life-threatening hypokalemic flaccid paralysis. Following resuscitation, extensive investigation showed that the patient had lupus erythematosus (SLE) and Sjogren's syndrome (SS) of which she was unaware. A search for the cause of the profound hypokalemia led to the finding of obligatory renal potassium wasting due to distal renal tubular acidosis (RTA), secretory type. The acid base status of the patient showed hyperchloremic metabolic acidosis compatible with distal renal tubular acidosis. Our case is a further proof that patients with "overlap syndrome" (SLE-SS) may have RTA, which may lead to life-threatening hypokalemia. Others have shown that the SLE-SS complex may occasionally be complicated by hyperkalemia. Thus, an autoimmune disease that is relatively common may present with devastating electrolyte abnormalities.
我们描述了一名患者，她以危及生命的低钾性弛缓性麻痹急剧就诊。复苏后，广泛检查显示该患者患有红斑狼疮（SLE）和干燥综合征（SS），而她对此并不知晓。对严重低钾血症病因的追查发现，其原因是分泌型远端肾小管酸中毒（RTA）导致的强制性肾钾流失。患者的酸碱状态显示为与远端肾小管酸中毒相符的高氯性代谢性酸中毒。我们的病例进一步证明，患有“重叠综合征”（SLE - SS）的患者可能会出现RTA，这可能导致危及生命的低钾血症。其他人已经表明，SLE - SS复合体偶尔可能并发高钾血症。因此，一种相对常见的自身免疫性疾病可能会出现严重的电解质异常。
