Recurrent Hypokalemic Paralysis in Sjögren's Syndrome with Distal Renal Tubular Acidosis: A Case Report

Sjögren氏症候群併發遠端型腎小管酸血症導致反覆性低鉀血性下肢癱瘓：病例報告

葉文將(Wen-Jiang Yeh) ； 鄭賀雄(He-Hsiung Cheng) ； 楊允輔(Yun-Fu Yang) ； 顏慕庸(Muh-Yong Yeh) ； 許秉毅(Ping-I Hsu) ； 陳志中(Chih-Chung Chen) ； 張朝煜(Chau-Yu Chang) ； 王漢文(Han-Wen Wang)

《中華民國急救加護醫學會雜誌》 7卷2期 (1996/06) Pp. 69-73

https://doi.org/10.30018/JECCM.199606.0004

摘要

一位六十三歲男性病患屢次因下肢癱瘓、四肢癱瘓甚至急性呼吸衰竭而被送至急診室，低鉀血症合併肌肉無力為初步臆斷，後來抽血發現存在有正常陰離子隙代謝性酸中毒，而且尿中pH值偏高，而懷疑有遠端型腎小管酸血症，詳細的病史詢問及身體檢查發現該病患早已有乾眼乾口症，經唇部唾液腺切片，腎臟切片及血清抗體檢查證實為Sjgren氏症候群。

關鍵字

Sjögren氏症候群 ； 低鉀血性下肢癱瘓 ； 遠端型腎小管酸血症 ； 乾眼乾口症候群

並列摘要

We report a 63-year-old man with Sjögren's syndrome, complicated with distal renal tubular acidosis, recurrent hypokalemic paralysis and acute respiratory failure. The sicca syndrome (dry eye & dry mouth), typical manifestation of Sjögren's syndrome, was initially subclinical and went unrecognized for several years. He presented to our emergency department with hypokalemic paralysis. Concomitant hyperchloremic metabolic acidosis led to the diagnosis of distal renal tubular acidosis. Sjögren's syndrome is an uncommon condition which may present as hypokalemic paralysis. If during your history taking or physical examination you note evidence of decreased glandular secretions or laboratory investigations suggest RTA, this diagnosis should be pursued at the time of admission.

並列關鍵字

Sjögren's syndrome ； hypokalemic paralysis ； distal renal tubular acidosis ； sicca syndrome