A Case of Distal Renal Tubular Acidosis and Sjögren’s Syndrome in a Patient with Autoimmune Thyroiditis

Korean Journal of Nephrology 2010;29(1):89-93.

Hye Rim An, M.D.1, Sung Chang Bae, M.D.1, Ki Byung Lee, M.D.1 Yong Kyu Lee, M.D.1, Jwa-Kyung Kim, M.D.1, Hyeong Cheon Park, M.D.1 Sung Kyu Ha, M.D.1 and Jung Eun Lee, M.D.2

Department of Internal Medicine¹
Gangnam Severance Hospital, Department of Internal Medicine²
Yongin Severance Hospital Yonsei University College of Medicine, Seoul, Korea

증례 : 자가 면역성 갑상선염 환자에서 발생한 쇼그렌 증후군과 원위 세뇨관 산증 1예

안혜림, 배성창,이기병,이용규, 김좌경, 박형천, 하성규, 이정은

연세대학교 의과대학 강남세브란스병원 내과학교실1 , 용인세브란스병원 내과학교실2

Abstract

A 52-year old woman, who had hypothyroidism associated with autoimmune thyroiditis for 5 years, was hospitalized for tingling sensation and muscle weakness of both lower extremities. Her initial laboratory findings showed severe hypokalemia, metabolic acidosis, and high titer of thyroid autoimmune antibodies. She was diagnosed of distal renal tubular acidosis by bicarbonate loading test (FEHCO3 - <3.0 %) and renal calcifications on pre-enhanced CT scan. Since she had other symptoms of xerostomia and xerophthalmia, primary Sjögren’s syndrome was diagnosed by Schirmer test, salivary scan, and serologic findings. She was treated with potassium citrate, potassium chloride, and hydroxychlorquine. Four months later, she has remained well with those treatments. There were only a few case reports about distal renal tubular acidosis associated with Sjögren’s syndrome and autoimmune thyroiditis. In Korea, there has not been any report of such cases. Therefore, we report a case of distal renal tubular acidosis and Sjögren’s syndrome in a patient with autoimmune thyroiditis.

Key Words: Autoimmune thyroiditis, Renal tubular acidosis, Sjögren’s syndrome