A Case of Sj gren's Syndrome Presented as Hypokalemic Periodic Paralysis due to Distal Renal Tubular Acidosis .
- Author:
Young Hwan PARK
1
;
Kyung No LEE
;
Hun Ho SONG
;
Mi Kyoung LIM
;
You Sook CHO
;
Won Seok YANG
;
Bin YOO
;
Hee Bom MOON
Author Information
1. Department of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Distal renal tubular acidosis;
Hypokalemia;
Periodic paralysis;
Sj gren's syndrome
- MeSH:
Acidosis, Renal Tubular*;
Arthritis, Rheumatoid;
Autoimmune Diseases;
Biopsy;
Follow-Up Studies;
Hydrogen-Ion Concentration;
Hypokalemia;
Hypokalemic Periodic Paralysis*;
Lip;
Lower Extremity;
Mouth;
Muscle Strength;
Myalgia;
Nausea;
Ophthalmic Solutions;
Paralysis;
Potassium;
Reference Values;
Sensation;
Serologic Tests;
Sodium Bicarbonate;
Vomiting
- From:The Journal of the Korean Rheumatism Association
1999;6(2):162-166
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Distal renal tubular acidosis (dRTA) can be associated with some autoimmune disease such as systemic lupus erytheuatosus, Sj gren's syndrome, and rheumatoid arthritis. Although hypokalemia in Sj gren's syndrome is a frequent complication, severe symptomatic hypokalemia has been reported only in few cases. Recently we experienced a case of Sj gren's syndrome diagnosed after the discovery of distal renal tubular acidosis with severe hypokalemia manifestating periodic weakness, myalgia in lower extremities, nausea, vomiting, and flaccid paralysis. She complained continuous sensation of dryness of her eyes and mouth. After the Schirmer's test, salivary scan, serologic tests, and lip biopsy, Sj gren's syndrome was confirmed. Intravenous and oral potassium replacement was started immediately, oral sodium bicarbonate later. Marked improvement in periodic paralysis was noted within a few hours and she was fully regained her muscle strength within 48 hours. She discharged with oral sodium bicarbonate and artificial tears. With this treatment blood pH and potassium were kept in the normal range during follow up visits.
