Long-term low-dose glucocorticoid therapy associated with remission of overt renal tubular acidosis in Sjögren's syndrome

El‐Mallakh, Rif S.; Bryan, RJ; Masi, Alfonse T.; Kelly, Charles E.; Rakowski, K.J.

doi:10.1016/0002-9343(85)90040-3

Cited by 34 publications

(14 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…They suggested that steroid therapy should be considered in patients with hypokalemic paralysis who do not respond to replacement treatment and in patients with recurring attacks (6). On the other hand, some authors have not administered steroid therapy for similar patients (4,14). In the present case, our patient had frequent episodes of hypokalemic quadriparesis due to dRTA.…”

Section: Discussionmentioning

confidence: 56%

Recurrent Attacks of Hypokalemic Quadriparesis: An Unusual Presentation of Primary Sjögren Syndrome

et al. 2016

View full text Add to dashboard Cite

We herein report the case of a 64-year old woman with recurrent attacks of hypokalemic quadriparesis which resulted from distal renal tubular acidosis (dRTA) secondary to Sjögren syndrome. The patient presented with sudden onset quadriparesis. A physical examination showed symmetric weakness of all four limbs. Severe hypokalemia (1.8 mEq/L), accompanied by normal anion gap metabolic acidosis, a positive urine anion gap and an inappropriately high urine pH pointed toward the diagnosis of dRTA. Further investigations disclosed primary Sjögren syndrome, which had not previously been recognized. On the basis of the current report and a review of the literature we suggest investigating the possibility of Sjögren syndrome in all patients with clinically unexplained dRTA.

show abstract

Section: Discussionmentioning

confidence: 56%

Recurrent Attacks of Hypokalemic Quadriparesis: An Unusual Presentation of Primary Sjögren Syndrome

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The renal biopsies performed in 4 of our initial patients with Sjögren's syndrome with renal failure had revealed features of chronic interstitial nephritis, hence the presumption that patients with Sjögren's syndrome with normal renal function may merit steroid therapy for effective treatment of acute interstitial nephritis. (c) Though there was uncertainty of reversal of florid interstitial infiltrate with steroid treatment, there were reports of remission of RTA [43,44] with the steroid therapy. (d) One opinion was that the interstitial nephritis was due to hypokalemia which was again due to RTA [9,45].…”

Section: Discussionmentioning

confidence: 99%

Renal Tubular Acidosis in Sjögren's Syndrome: A Case Series

2014

View full text Add to dashboard Cite

Background: The exact frequency of distal and proximal renal tubular acidosis (RTA) in Sjögren's syndrome is unknown. Other features of Sjögren's syndrome like polyuria, glomerular manifestations, familial occurrence and pregnancy are not widely reported. The aim was to prospectively study the clinical features and outcome of distal and proximal RTA in Sjögren's syndrome and also report on other renal manifestations of Sjögren's syndrome. Methods: The present study is a prospective consecutive case series of patients who presented with a history suggestive of RTA and Sjögren's syndrome. All patients were followed for 1 year. The diagnosis of RTA was by fractional excretion of bicarbonate. The diagnosis of Sjögren's syndrome was according to the American-European classification system [modified by Tzioufas and Voulgarelis: Best Pract Res Clin Rheumatol 2007;21:989-1010]. Results: The total number of RTA patients diagnosed during this period was 149. Sjögren's syndrome accounted for 34.8% (52 of 149) of RTA patients. The important symptoms and laboratory parameters were oral and ocular symptoms in 23 (44.2%), dental caries in 12 (23%), body pains in 47 (90.3%), mean serum pH 7.202 ± 0.03, mean serum bicarbonate, 14.03 ± 1.66 mmol/l, and mean urine pH, 7.125 ± 0.54. There were 30 (57.6%) patients with distal RTA and 22 (42.3%) patients with proximal RTA. Conclusions: The clinical implication of the present study is that RTA is a common feature of Sjögren's syndrome. It may be missed if the presentation is not due to oral and ocular symptoms. The present study is also the only one with a 1-year follow-up.

show abstract

“…Besides this, there are a few reports on the successful treatment of SS-associated RTA1 with corticosteroids. 10,12 These authors mentioned that steroid therapy should be considered in SS-associated RTA1 cases with renal infiltrates of interstitial plasma cells and lymphocytes or with HPP. Our patient showed both RTA1 and HPP in addition to signs of active interstitial nephritis and impaired renal function.…”

Section: Discussionmentioning

confidence: 99%

Hypokalemic paralysis and osteomalacia secondary to renal tubular acidosis in a case with primary Sjögren's syndrome

Kawashima

Amano²,

Morita

et al. 2006

Mod Rheumatol

View full text Add to dashboard Cite

A 39-year-old Japanese woman was admitted to our hospital for severe weakness owing to potassium deficiency caused by type 1 renal tubular acidosis (RTA1). Sicca complex, serological tests, and lip biopsy revealed that she had Sjögren's syndrome (SS). Acidosis was corrected by alkali supplement treatment. She also had an impaired renal function with proteinuria, and high absorbance on Ga scintigram was recognized in both kidneys. She was taking warfarin potassium after aortic valve substitution due to aortic regurgitation, therefore renal biopsy was not performed. Prednisone (20 mg/day) was administered for renal inflammation. One month later, she suffered severe chest wall pains with some local tender points over the costae of both sides, which was presumed to be due to pseudo-fractures based on osteomalacia. Hypokalemic paralysis and osteomalacia should be taken into consideration in the diagnosis of SS with RTA1.

show abstract

Long-term low-dose glucocorticoid therapy associated with remission of overt renal tubular acidosis in Sjögren's syndrome

Cited by 34 publications

References 12 publications

Recurrent Attacks of Hypokalemic Quadriparesis: An Unusual Presentation of Primary Sjögren Syndrome

Recurrent Attacks of Hypokalemic Quadriparesis: An Unusual Presentation of Primary Sjögren Syndrome

Renal Tubular Acidosis in Sjögren's Syndrome: A Case Series

Hypokalemic paralysis and osteomalacia secondary to renal tubular acidosis in a case with primary Sjögren's syndrome

Contact Info

Product

Resources

About