Sjögren's syndrome, tubular acidosis and nephrocalcinosis

Branka Sošić, Marijana Tomić Smiljanić

Keywords: Sjögren's syndrome, tubular acidosis and nephrocalcinosis

Introduction:

Sjögren's syndrome is an autoimmune disease characterized by dry mucous membranes of the eyes and oral cavity. The incidence of tubulopathy ranges from 2.6 to 33
GOAL: Indicate possible tubular acidosis and nephrocalcinosis in Sjögren's syndrome
METHOD: Conversation with the patient, examination, discharge lists, medical specialist assessment reports, laboratory analyses
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Case:

CASE REPORT: A 28-year-old patient complained of dry mouth and eyes due to parotitis. Schirmer'stestrevealed OD 12mm, OS 8mm, BUT 11.9sec. No synovitis of peripheral joints. Immunological tests performed included RF 63, ANA 1/640, anti-Ro 241.6, anti-La neg. Ultrasonographic changes of the salivary glands were highly suggestive of Sjögren's syndrome. Artificial tears and artificial saliva preparations were introduced into the therapy. After a year, the patient developed pain in the joints and bruising on the body. Hematological examination showed a slightly reduced F XII value. The existence of antiphospholipid antibodies was not confirmed, and elevated protein values with polyclonal hypergammaglobulinemia were most likely the result of immune stimulation within the autoimmune process. The rheumatologist introduced Prednisone and Chloroquine Phosphateinto the therapy. After two years, the patient woke up at night to numbness and inability to walk. She reported to the Emergency Center, hypokalemia was 1.7, GFR> 60. She was hospitalized in the nephrology ward, where she was diagnosed with renal tubular acidosis II and nephrocalcinosis within Sjögren's syndrome. Potassium chloride substitute 3x1 gr was introduced into the therapy, chloroquine phosphate was replaced by hydroxychloroquine.

Discussion:

CONCLUSION: Patients with Sjögren's syndrome should have their potassium level measured, urinary tract ECHO test, and gas test performed timely

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