Sjogren’s syndrome Associated with Type 1 Renal Tubular Acidosis and Severe Hypokalemia: A Case Study View PDF

^*Sahithi Gunduru
Sri Padmavathi Medical College For Women, SVIMS University, Andhra Pradesh, India

^*Corresponding Author:

Sahithi Gunduru
Sri Padmavathi Medical College For Women, SVIMS University, Andhra Pradesh, India
Email:sahithigunduru01@gmail.com

Published on: 2023-01-03

Abstract

Sjogren’s syndrome (SS) is a chronic autoimmune inflammatory condition that primarily involves exocrine glands like the glands of saliva and tears. SS also involves extra-glandular involvement with renal involvement in the form of tubulointerstitial nephritis, followed by glomerulonephritis, distal renal tubular acidosis (RTA), and Fanconi syndrome. We report a case of type 1 RTA with severe hypokalemia caused by SS. ECG showed Sinus Bradycardia with QT prolongation with U waves. USG’s abdomen showed nephrolithiasis of size 4 mm in the left kidney. Diagnosis of distal RTA type 1 associated with SS was based on the above findings. This case emphasizes the need to evaluate for autoimmune conditions when a patient presents with Distal RTA.

Keywords

Distal Renal Tubular Acidosis, Hypokalemia, Sjogren’s Syndrome

Introduction

Dry eyes and xerostomia are two symptoms of the chronic, slowly progressing autoimmune condition known as Sjogren’s syndrome (SS) [1]. Additionally, it affects lacrimal, salivary, and exocrine glands as well as extracorporeal organs such as the liver and kidney [2]. The clinical signs of SS are varied, making it simple to misdiagnose or even go unnoticed [2]. Gradually, it may cause serious acid-base imbalances, including hyperchloremic metabolic acidosis and fatally low levels of potassium [3]. Tubulointerstitial Nephritis (TIN) is the most frequent histological abnormality, with Glomerulonephritis as second, according to biopsy data available in the literature [4]. Although TIN is the most frequent histology result, hypokalaemia with biochemical evidence of distal renal tubular acidosis (RTA) has very occasionally been described [4].