A CASE OF PROBABLE SJOGRENS SYNDROME PRESENTING WITH HYPOKALEMIC PARALYSIS AND INCIDENTAL CHRONIC HEPATITIS B VIRUS INFECTION
Abstract
Sjogren’s syndrome is relatively rare in males, with female to male incidence ratio of 16:1. It is an autoimmune disorder characterized by lymphocytic infiltration of exocrine glands. However, the disease may be associated with extra glandular manifestation affecting multiple organs.
We report one such uncommon presentation where a 19-year-old male was brought to our emergency department with chief complaint of weakness of all four limbs. He had hypokalemia at admission.
Upon further evaluation, we diagnosed this case as probable Sjogren’s syndrome with distal renal tubular acidosis (dRTA) which caused the hypokalemia.
Incidentally he was found having chronic hepatitis B virus infection. This association of hepatitis virus infection and Sjogren’s syndrome is rarely described in the literature.Keywords
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Qin B, Wang J, Yang Z, et al. Epidemiology of primary Sjögren’s syndrome: a systematic review and meta-analysis. Ann Rheum Dis. 2014;74:1983-1989.
Shiboski SC, Shiboski CH, Criswell LA, et al. American College of Rheumatology classification criteria for Sjögren’s syndrome: a data-driven, expert consensus approach in the Sjögren’s International Collaborative Clinical Alliance cohort. Arthritis Care Res. 2012;64(4):475-487.
Bossini N, Savoldi S, Franceschini F, et al. Clinical and morphological features of kidney involvement in primary Sjögren’s syndrome. Nephrol Dial Transplant. 2001;16(12): 2328-2336.
Maripuri S, Grande JP, Osborn TG, et al. Renal involvement in primary Sjögren’s syndrome: a clinicopathologic study. Clin J Am Soc Nephrol. 2009;4(9):1423-1431.
Pun KK, Wong CK, Tsui EY, Tam SC, Kung AW, Wang CC. Hypokalemic periodic paralysis due to the Sjögren syndrome in Chinese patients. Ann Intern Med. 1989;110(5):405-406.
Ohtani H, Imai H, Kodama T, et al. Severe hypokalaemia and respiratory arrest due to renal tubular acidosis in a patient with Sjogren syndrome. Nephrol Dial Transplant. 1999;14:2201- 2203.
Skalova S, Minxova L, Slezak R. Hypokalaemic paralysis revealing Sjogren’s syndrome in a 16-year old girl. Ghana Med J. 2008;42(3):124-128.
Vaidya G, Ganeshpure S. Sjogren’s syndrome with distal renal tubular acidosis presenting as hypokalaemic paralysis. BMJ. 2012;10:1-3.
Jason An and Branko Braam. Complete Hypokalemic Quadriparesis as a First Presentation of Sjögren SyndromeCanadian Journal of Kidney Health and Disease Volume 5: 1–8
Miguel Marcos, Fausto Alvarez, Pilar Brito-Zerón, Albert Bove, Marta Perez-De-Lis, Candido Diaz-Lagares, Jose-Maria Sanchez-Tapias, Manuel Ramos-Casals . Chronic hepatitis B virus infection in Sjögren's syndrome. Prevalence and clinical significance in 603 patients. Autoimmunity Reviews 8 (2009) 616–620
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