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Authors

 

Sonja Golubović¹, Tatjana Ilić^1,2, Biljana Milić^1,2, Dejan Ćelić^1,2, Igor Mitić<sup>1,2

1</sup>Klinički centar Vojvodine, Klinika za nefrologiju i kliničku imunologiju, Hajduk Veljkova 1 21000 Novi Sad, Srbija
²Univerzitet u Novom Sadu, Medicinski fakultet, Hajduk Veljkova 1, 21000 Novi Sad, Srbija

 

UDK: 616.316
616.61-002

The paper was received / Rad primljen: 09.10.2018.

Accepted / Rad prihvaćen: 12.10.2018

 

Correspondence to:

Dr Sonja Golubović
Klinički centar Vojvodine, Klinika za nefrologiju i kliničku imunologiju,
Hajduk Veljkova 1 21000 Novi Sad, Srbija,
21204 Sremska Kamenica, Serbia
Tel: +381644090506
e-mail: sonjagolubovic@gmail.com

 

 

Sažetak

 

Uvod: Sjögrenov sindrom je hronična sistemska bolest vezivnog tkiva koja zahvata razne organe, a primarno egzokrine žlezde. Predstavićemo slučaj bolesnice sa hipo­kalemijskom kvadriparezom nastalom kao posledica tubulointersticijskog nefritisa i renalne tubularne acidoze a kao jedna od manifestacija Sjögrenovog sindroma. Prikaz slučaja: Žena starosti 41 godinu primljena u Urgentni centar zbog prisustva tegoba u vidu slabosti, bolova u mišićima i otežanom pokretljivošću sva četiri ekstremiteta. Dijagnoza primarnog Sjögrenovog sindroma je postavljena 11 godna ranije. Inicijalne laboratorijske analize pokazale su izraženu hipokalijemiju sa metaboličkom acidozom, ubrzanu sedimentaciju, hiperhloremiju i hipernatrijemiju. Imunoserološki testovi su potvrdili prisu­stvo tačkastih antinuklearnih antitela uz prisustvo anti-SSA i anti-SSB antitela. Nalaz imunofluorescentne mikroskopije bioptata bubrega ukazala je na gusto infiltrisan hipe­rcelularni intersticijumski segment bez prisustva imunofluorescentnih depozita unutar glomerula. Analiza svetlosne mikroskopije se uklapala u kliničku sliku tubulo­inter­sticijskog nefritisa. Zaključak: Jedan od prezentujućih znakova autoimunog obo­ljenja može biti nespecifičan što je prikazano u ovom slučaju gde hipokalijemijska paraliza i renalni kalkulusi mogu biti pokazatelji prisustva distalne renalne tubularne acidoze.

 

 

Ključne reči:

hipokalijemijska paraliza, intersticijumski nefritis, renalna tubularna acidoza, Sjögrenov sindrom

 

 

Abstract

 

Introduction: Sjögren’s syndrome  is a chronic systemic connective tissue disease which can affect multiple visceral organs, primarily affecting exocrine glands. We present a case of a patient with hypokalemic quadriparesis due to tubulointerstital nephritis and renal tubular acidosis, as a manifestation of Sjögren’s syndrome. Case Outline: A 41-year-old woman was admitted to the emergency room due to weakness, muscle pain, difficulties walking and moving all four limbs. She was diagnosed with primary Sjögren’s syndrome 11 years earlier. Laboratory results showed extreme hypokalemia with metabolic acidosis, increased erythrocyte sedimentation rate, hyperchloremia and hypernatremia. Imunoserologic tests confirmed the presence of speckled ANA with the presence of anti SSA and anti SSB antibodies. Imunofluorescent microscopy of the renal biopsy sample revealed a densely infiltrated hypercellular interstitial segment without presence of imunofluorescent deposits within the glomerulus. Тhe finding of light microscopic analysis fits into the clinical picture of tubulointerstitial nephritis. Conclusion: One of presenting signs of an autoimmune disease can be unspecific, such as hypokalemic paralysis and renal calculi which could further indicate the presence of distal renal tubular acidosis.

 

 

Key words:

Hypokalemic paralysis, interstitial nephritis, renal tubular acidosis, Sjögren’s syndrome

 

 

References:

 

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PDF Golubović S. et al. • MD-Medical Data 2018;10(4): 197-200