Nephrocalcinosis and proximal tubulopathy in Sjögren's Syndrome.
DOI:
https://doi.org/10.31053/1853.0605.v75.n2.19161Keywords:
nephrocalcinosis, renal tubular acidosis, primary Sjögren’s syndrome,Abstract
Primary Sjögren's syndrome is a systemic and chronic autoimmune disease. Renal involvement may occur in up to 30% of patients. The incidence of tubulopathies ranges from 2.6 to 33%. They are manifested by defects in the urine concentration and hydroelectrolyte alterations, mainly distal tubular acidosis and exceptionally proximal tubular acidosis. These disorders can be associated with nephrocalcinosis and renal lithiasis.
We report the case of a patient with primary Sjögren who presented proximal renal tubular acidosis associated with recurrent renal colic due to renal lithiasis and nephrocalcinosis.
We highlight the importance of diagnosing renal tubular acidosis in patients with Sjögren's syndrome that present alterations in urinary sediment and electrolyte disorders to avoid nephrocalcinosis and nephrolithiasis. Acidosis correction treatment aims to prevent the progression of the disorder and preserve renal function.
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References
Brito-Zerón P, Baldini C, Bootsma H, et al. Sjögren syndrome. Nat Rev Dis Primers. 2016 Jul 7;2:16047.
Ramos-Casals M, Brito-Zerón P, Seror R, et al. Characterization of systemic disease in primary Sjögren's syndrome: EULAR-SS Task Force recommendations for articular, cutaneous, pulmonary and renal involvements. Rheumatology. 2015;54(12):2230–2238.
François H, Mariette X. Renal involvement in primary Sjögren syndrome.Nat Rev Nephrol. 2016 Feb;12(2):82-93.
Evans R, Zdebik A, Ciurtin C, Walsh SB. Renal involvement in primary Sjögren’s syndrome. Rheumatology (Oxford). 2015; 54:1541–8.
Goules AV,Tatouli IP, Moutsopoulos, HM, Tzioufas AG. Clinically significant renal involvement in primary Sjögren’s syndrome: clinical presentation and outcome. Arthritis Rheum. 65, 2945–2953 (2013).
Evans RDR, Laing CM, Ciurtin C, Walsh SB. Tubulointerstitial nephritis in primary Sjögren syndrome: clinical manifestations and response to treatment. BMC Musculoskeletal Disorders. 2016;5(17):p. 2.
Maripuri S, Grande JP, Osborn TG, et al. Renal involvement in primary sjögren's syndrome: a clinicopathologic study. Clinical Journal of the American Society of Nephrology. 2009;4(9):1423–1431.
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.
Haque SK, Ariceta G, Batlle D. Proximal renal tubular acidosis: a not so rare disorder of multiple etiologies. Nephrol. Dial. Transplant. 27, 4273–4287 (2012).
Polanco NA, Soto-Abraham MV, Rodríguez-Castellanos FE. Nephrocalcinosis and distal renal tubular acidosis in Sjögren's syndrome. Nefrologia 2013;33:860-1.
Rajput R, Sehgal A, Jain D, Sen R, Saini O. Nephrocalcinosis: a rare presenting manifestation of primary Sjögren's syndrome. Mod Rheumatol. 2012 Jun;22(3):479-82.
Gharbi C, Rottembourg J, and Izzedine H. Nephrocalcinosis in primary Sjögren's syndrome. Clin Kidney J. 2014 Apr; 7(2): 217.
Cheidde L, Ajzen SA, Tamer Langen CH, Christophalo D, Heilberg IP. A critical appraisal of the radiological evaluation of nephrocalcinosis. Nephron Clin Pract. 2007;106(3):c119.
Boyce AM, Shawker TH, Hill SC, et al. Ultrasound is superior to computed tomography for assessment of medullary nephrocalcinosis in hypoparathyroidism. The Journal of clinical endocrinology and metabolism. 2013;98:989–94.
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