Renal Tubular Acidosis, Glomerulonephritis and Immunologic Factors in Sjogren's Syndrome

Abstract

Urinary acidification was impaired in 6 of 12 patients with Sjogren's syndrome (SS) studied before and during the administration of ammonium chloride. Renal tubular acidosis was overt in 3 patients and subclinical in 2. The sixth patient had glomerulonephritis. Precipitating antibodies to tissue antigens were studied in 70 patients with SS. The group with renal disease had the greatest reactivity, and the only reactivity to heat denatured DNA. None of the 70 patients reacted with native DNA, and only one with nucleoprotein.

Antibodies to cellular antigens in Sjögren's syndrome.

“…Immunodiffusion in gel has been used to detect serum precipitating antibodies to tissue antigens (8)(9)(10)(11)(12). In these studies, extracts of human thyroid, spleen, and calf thymus nuclei have been used.…”

Type II Diabetes Mellitus and Primary Sjoegren's Syndrome Complicated by Pleural Effusion.

“…It is important to rule out renal involvement due to Sjs. Twenty-five to fifty percent of patients with primary Sjs have associated renal lesions (17,18). However, in general, interstitial nephritis is a more commonfinding than glomerulonephritis (17,18).…”

“…Twenty-five to fifty percent of patients with primary Sjs have associated renal lesions (17,18). However, in general, interstitial nephritis is a more commonfinding than glomerulonephritis (17,18). It is unclear whether tubulointerstitial damage in our patient was associated with a secondary change due to the advanced diabetic nephropathy or associated with the Sjs.…”

“…It is unclear whether tubulointerstitial damage in our patient was associated with a secondary change due to the advanced diabetic nephropathy or associated with the Sjs. Defects in renal acidification occur regularly in patients with Sjs, and distal renal tubular acidosis and a defect in urinary concentrating ability are almost invariably associated with hypokalemic, hyperglobulinemia, which is a serologic marker for severe chronic tubulointerstitial injury with Sjs (17,18). However, our patient did not have renal tubular acidosis, hypokalemia, or urinary concentrating abnormality.…”

Renal Involvement in Rheumatic Diseases

“…The prevalence rate of this disease in women is 9 times higher than that of men [18]. However, the exact prevalence of pSS due to continuous changes in diagnostic guidelines and differentiation from secondary pSS is difficult to determine [19]. pSS can involve multiple organs including the kidney, joints, lungs, hematologic system, vascular system, and peripheral nervous system as well as exocrine glands [20].…”