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Case Reports in Rheumatology
Volume 2017, Article ID 7509238, 7 pages
https://doi.org/10.1155/2017/7509238
Case Report

Hypokalemic Paralysis due to Primary Sjögren Syndrome: Case Report and Review of the Literature

Servicio de Reumatología, Departamento de Medicina Interna, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico

Correspondence should be addressed to A. C. Arana-Guajardo; moc.liamg@ganara.ana

Received 29 March 2017; Revised 14 June 2017; Accepted 2 July 2017; Published 1 August 2017

Academic Editor: Syuichi Koarada

Copyright © 2017 A. Garza-Alpirez et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. R. Evans, A. Zdebik, C. Ciurtin, and S. B. Walsh, “Renal involvement in primary Sjögren's syndrome,” Rheumatology, vol. 54, no. 9, pp. 1541–1548, 2015. View at Publisher · View at Google Scholar · View at Scopus
  2. M. Ramos-Casals, P. Brito-Zerón, R. Seror et al., “Characterization of systemic disease in primary Sjögren's syndrome: EULAR-SS Task Force recommendations for articular, cutaneous, pulmonary and renal involvements,” Rheumatology, vol. 54, no. 12, pp. 2230–2238, 2015. View at Publisher · View at Google Scholar · View at Scopus
  3. M. Ramos-Casals, P. Brito-Zerón, R. Solans et al., “Systemic involvement in primary Sjögren's syndrome evaluated by the EULAR-SS disease activity index: Analysis of 921 spanish patients (GEAS-SS registry),” Rheumatology (United Kingdom), vol. 53, no. 2, Article ID ket349, pp. 321–331, 2014. View at Publisher · View at Google Scholar · View at Scopus
  4. H. Ren, W. M. Wang, X. N. Chen, W. Zhang, X. L. Pan Wang et al., “Renal involvement and followup of 130 patients with primary Sjögren's syndrome,” The Journal of Rheumatology, vol. 35, pp. 278–284, 2008. View at Google Scholar
  5. D. M. Chisholm and D. K. Mason, “Labial salivary gland biopsy in Sjögren's disease,” Journal of Clinical Pathology, vol. 21, no. 5, pp. 656–660, 1968. View at Publisher · View at Google Scholar · View at Scopus
  6. C. H. Shiboski, S. C. Shiboski, R. Seror et al., “2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sjogren's syndrome A consensus and data-driven methodology involving three international patient cohorts,” Annals of the Rheumatic Diseases, vol. 76, no. 1, pp. 9–16, 2016. View at Publisher · View at Google Scholar
  7. N. Talal, E. Zisman, and P. H. Schur, “Renal tubular acidosis, glomerulonephritis and immunologic factors in Sjogren's syndrome,” Arthritis and Rheumatology, vol. 11, no. 6, pp. 774–786, 1968. View at Publisher · View at Google Scholar · View at Scopus
  8. S. Maripuri, J. P. Grande, T. G. Osborn et al., “Renal involvement in primary sjögren's syndrome: a clinicopathologic study,” Clinical Journal of the American Society of Nephrology, vol. 4, no. 9, pp. 1423–1431, 2009. View at Publisher · View at Google Scholar · View at Scopus
  9. N. Bossini, S. Savoldi, F. Franceschini et al., “Clinical and morphological features of kidney involvement in primary Sjögren's syndrome,” Nephrology Dialysis Transplantation, vol. 16, no. 12, pp. 2328–2336, 2001. View at Publisher · View at Google Scholar · View at Scopus
  10. H. François and X. Mariette, “Renal involvement in primary Sjögren syndrome,” Nature Reviews Nephrology, vol. 12, no. 2, pp. 82–93, 2016. View at Publisher · View at Google Scholar · View at Scopus
  11. B. Bastani, L. Haragsim, S. Gluck, and K. C. Siamopoulos, “Lack of h-atpase in distal nephron causing hypokalaemic distal rta in a patient with sjögren’s syndrome,” Nephrology Dialysis Transplantation, vol. 10, no. 6, pp. 908-909, 1995. View at Publisher · View at Google Scholar · View at Scopus
  12. F. Takemoto, J. Hoshino, N. Sawa et al., “Autoantibodies against carbonic anhydrase II are increased in renal tubular acidosis associated with Sjögren syndrome,” American Journal of Medicine, vol. 118, no. 2, pp. 181–184, 2005. View at Publisher · View at Google Scholar · View at Scopus
  13. P. E. DeFranco, L. Haragsim, P. G. Schmitz, B. Bastani, and J. P. Li, “Absence of vacuolar H+-ATPase pump in the collecting duct of a patient with hypokalemic distal renal tubular acidosis and Sjögren's syndrome,” Journal of the American Society of Nephrology, vol. 6, no. 2, pp. 295–301, 1995. View at Google Scholar · View at Scopus
  14. P. Sandhya and D. Danda, “Role of vacuolar ATPase and Skp1 in Sjögren's syndrome,” Medical Hypotheses, vol. 82, no. 3, pp. 319–325, 2014. View at Publisher · View at Google Scholar · View at Scopus
  15. P. Eriksson, T. Denneberg, S. Eneström, B. Johansson, F. Lindström, and T. Skogh, “Urolithiasis and distal renal tubular acidosis preceding primary Sjögren's syndrome: A retrospective study 5-53 years after the presentation of urolithiasis,” Journal of Internal Medicine, vol. 239, no. 6, pp. 483–488, 1996. View at Publisher · View at Google Scholar · View at Scopus
  16. S.-H. Lin, S. Cheema-Dhadli, M. Gowrishankar, E. B. Marliss, K. S. Kamel, and M. L. Halperin, “Control of excretion of potassium: lessons from studies during prolonged total fasting in human subjects,” American Journal of Physiology—Renal Physiology, vol. 273, no. 5, pp. F796–F800, 1997. View at Google Scholar · View at Scopus
  17. R. Shioji, T. Furuyama, S. Onodera, H. Saito, H. Ito, and Y. Sasaki, “Sjögren's syndrome and renal tubular acidosis,” The American Journal of Medicine, vol. 48, no. 4, pp. 456–463, 1970. View at Publisher · View at Google Scholar · View at Scopus
  18. K.-K. Pun, C.-K. Wong, E. Y.-L. Tsui, S. C.-F. Tam, A. W.-C. Kung, and C. C.-L. Wang, “Hypokalemic periodic paralysis due to the Sjogren syndrome in Chinese patients,” Annals of Internal Medicine, vol. 110, no. 5, pp. 405-406, 1989. View at Publisher · View at Google Scholar · View at Scopus
  19. R. D. R. Evans, C. M. Laing, C. Ciurtin, and S. B. Walsh, “Tubulointerstitial nephritis in primary Sjögren syndrome: clinical manifestations and response to treatment,” BMC Musculoskeletal Disorders, vol. 5, no. 17, p. 2, 2016. View at Publisher · View at Google Scholar · View at Scopus
  20. N. Talal, “Sjögren's syndrome, lymphoproliferation, and renal tubular acidosis,” Annals of Internal Medicine, vol. 74, no. 4, pp. 633-634, 1971. View at Publisher · View at Google Scholar · View at Scopus
  21. C.-J. Cheng, J.-S. Chiu, C.-C. Chen, and S.-H. Lin, “Unusual cause of hypokalemic paralysis in aged men: Sjögren syndrome,” Southern Medical Journal, vol. 98, no. 12, pp. 1212–1215, 2005. View at Publisher · View at Google Scholar · View at Scopus
  22. M. Goroshi, S. Khare, T. Jamale, and N. Shah, “Primary Sjogren's syndrome presenting as hypokalemic paralysis: a case series,” Journal of Postgraduate Medicine, vol. 63, no. 2, p. 128, 2016. View at Publisher · View at Google Scholar
  23. M. Soy, Ö. N. Pamuk, M. Gerenli, and Y. Çelik, “A primary Sjögren's syndrome patient with distal renal tubular acidosis, who presented with symptoms of hypokalemic periodic paralysis: report of a case study and review of the literature,” Rheumatology International, vol. 26, no. 1, pp. 86–89, 2005. View at Publisher · View at Google Scholar · View at Scopus
  24. R. Khadgawat, N. Tandon, D. Khandelwal, S. Bhattacharya, S. Kaur, and A. Ammini, “Hypokalemic paralysis as a presenting manifestation of primary Sjögren′s syndrome: a report of two cases,” Indian Journal of Endocrinology and Metabolism, vol. 16, no. 5, pp. 853–855, 2012. View at Publisher · View at Google Scholar
  25. M. Kawashima, T. Amano, Y. Morita, M. Yamamura, and H. Makino, “Hypokalemic paralysis and osteomalacia secondary to renal tubular acidosis in a case with primary Sjögren's syndrome,” Modern Rheumatology, vol. 16, no. 1, pp. 48–51, 2006. View at Publisher · View at Google Scholar · View at Scopus
  26. D. M. Comer, A. G. Droogan, I. S. Young, and A. P. Maxwell, “Hypokalaemic paralysis precipitated by distal renal tubular acidosis secondary to Sjögren's syndrome,” Annals of Clinical Biochemistry, vol. 45, no. 2, pp. 221–225, 2008. View at Publisher · View at Google Scholar · View at Scopus
  27. S. Seirafian, M. Shafie, A. Abedini, B. Pakzad, and P. Roomizadeh, “Recurrent attacks of hypokalemic quadriparesis: an unusual presentation of primary Sjögren syndrome,” Internal Medicine, vol. 55, no. 13, pp. 1797–1800, 2016. View at Publisher · View at Google Scholar · View at Scopus
  28. G. Vaidya and S. Ganeshpure, “Sjogren's syndrome with distal renal tubular acidosis presenting as hypokalaemic paralysis,” BMJ Case Reports, vol. 19, 2012. View at Publisher · View at Google Scholar · View at Scopus
  29. S. Sarah, G. Lijo, E. Sukanya, and D. Rajasekaran, “Renal tubular acidosis due to Sjogren's syndrome presenting as hypokalemic quadriparesis: a report of two cases,” Indian Journal of Nephrology, vol. 25, no. 6, pp. 386-387, 2015. View at Publisher · View at Google Scholar · View at Scopus
  30. N. Rao, M. John, N. Thomas, S. Rajaratnam, and M. S. Seshadri, “Aetiological, clinical and metabolic profile of hypokalaemic periodic paralysis in adults: a single-centre experience,” National Medical Journal of India, vol. 19, no. 5, pp. 246–249, 2006. View at Google Scholar · View at Scopus
  31. M. Nail, T. Bhat, M. Naqash et al., “Hypokalemic quadriparesis in an elderly female,” Indian Journal of Nephrology, vol. 22, no. 5, pp. 402-403, 2012. View at Publisher · View at Google Scholar · View at Scopus
  32. S. Rajagopala, G. Danigeti, and D. Subrahmanyan, “An unusually dry story,” Indian Journal of Critical Care Medicine, vol. 19, no. 9, pp. 550–553, 2015. View at Publisher · View at Google Scholar · View at Scopus
  33. A. V. Palkar, S. Pillai, and G. C. Rajadhyaksha, “Hypokalemic quadriparesis in Sjogren syndrome,” Indian Journal of Nephrology, vol. 21, no. 3, pp. 191–193, 2011. View at Publisher · View at Google Scholar · View at Scopus
  34. S. Dasari, K. Naha, G. Vivek, V. Acharya, and M. Hande, “Primary presentation with acute flaccid quadriparesis in Sjogren's syndrome sans sicca,” BMJ Case Reports, vol. 2013, 2013. View at Google Scholar · View at Scopus
  35. J. Singhvi, A. Ganguli, and B. Kaur, “Primary Sjogren's syndrome presenting as Acute Flaccid Quadriplegia,” Annals of Neurosciences, vol. 17, no. 2, 2010. View at Publisher · View at Google Scholar
  36. Y.-C. Chang, C.-C. Huang, Y.-Y. Chiou, and C.-Y. Yu, “Retal tubular acidosis complicated with hypokalemic periodic paralysis,” Pediatric Neurology, vol. 13, no. 1, pp. 52–54, 1995. View at Publisher · View at Google Scholar · View at Scopus
  37. I. Taylor and M. Parsons, “Hypokalemic paralysis revealing Sjögren's syndrome,” Journal of Clinical Neuroscience, vol. 11, no. 3, pp. 319–321, 2004. View at Publisher · View at Google Scholar · View at Scopus
  38. G. Carminati, A. Chena, J. M. Orlando, S. Russo, S. Salomón, and J. A. Carena, “Distal renal tubular acidosis with rhabdomyolysis as the presenting form in 4 pregnant women,” Nefrologia, vol. 21, no. 2, pp. 204–208, 2001. View at Google Scholar · View at Scopus
  39. J. Muthukrishnan, S. Dawra, V. Marwaha, and C. S. Narayanan, “Sjögren’s syndrome presenting as hypokalemic paralysis,” Medical Journal Armed Forces India, vol. 71, pp. S172–S174, 2015. View at Publisher · View at Google Scholar · View at Scopus
  40. E. B. S. Prakash, M. E. Fernando, M. Sathiyasekaran, R. M. Bhoopathy, J. J. Jayanth, and J. Samuel, “Primary Sjögren's syndrome presenting with distal renal tubular acidosis and rhabdomyolysis,” Journal of Association of Physicians of India, vol. 54, pp. 949-950, 2006. View at Google Scholar · View at Scopus
  41. S. Skalova, L. Minxova, and R. Slezak, “Hypokalaemic paralysis revealing Sjogren's syndrome in a 16-year old girl,” Ghana Medical Journal, vol. 42, pp. 124–128, 2008. View at Google Scholar
  42. C.-Y. Liao, C.-C. Wang, I.-H. Chen, J.-C. Shiang, M.-Y. Liu, and M.-K. Tsai, “Hypokalemic paralysis as a presenting manifestation of primary Sjögren's syndrome accompanied by vitamin D deficiency,” Internal Medicine, vol. 52, no. 20, pp. 2351–2353, 2013. View at Publisher · View at Google Scholar · View at Scopus
  43. E. Sengul, F. Bunul, A. Yazici et al., “An unusual initial presentation of Sjögren's syndrome: severe hypokalemic paralysis secondary to distal renal tubular acidosis,” Eurasian Journal of Medicine, vol. 45, no. 3, pp. 218–221, 2013. View at Publisher · View at Google Scholar · View at Scopus
  44. H. Yilmaz, M. Kaya, M. Özbek, K. Üreten, and S. I. Safa Yildirim, “Hypokalemic periodic paralysis in Sjogren's syndrome secondary to distal renal tubular acidosis,” Rheumatology International, vol. 33, no. 7, pp. 1879–1882, 2013. View at Publisher · View at Google Scholar · View at Scopus
  45. J. L. Logan and J. Ahmed, “Critical hypokalemic renal tubular acidosis due to Sjögren's syndrome: association with the purported immune stimulant echinacea,” Clinical Rheumatology, vol. 22, no. 2, pp. 158-159, 2003. View at Publisher · View at Google Scholar · View at Scopus
  46. T. Fujimoto, H. Shiiki, Y. Takahi, and K. Dohi, “Primary Sjögren's syndrome presenting as hypokalaemic periodic paralysis and respiratory arrest,” Clinical Rheumatology, vol. 20, no. 5, pp. 365–368, 2001. View at Publisher · View at Google Scholar · View at Scopus
  47. K. Mugundhan, M. C. Mayan Vasif, P. D. Nidhin et al., “Hypokalemic paralysis in Sjogren’s syndrome secondary to renal tubular acidosis,” Journal of Association of Physicians of India, vol. 64, p. 72, 2016. View at Google Scholar · View at Scopus