一名远端肾小管酸中毒患者同时患有斯约格伦综合征相关性间质性肾炎和低钾血症肾病：病例报告。

IF 1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Internal Medicine Pub Date : 2025-04-01 Epub Date: 2024-08-28 DOI:10.2169/internalmedicine.4152-24

Rena Matsui, Maika Gojo, Kohei Odajima, Shinichiro Asakawa, Shigeyuki Arai, Osamu Yamazaki, Yoshifuru Tamura, Satoe Numakura, Yasutoshi Oshima, Ryuji Ohashi, Shigeru Shibata, Yoshihide Fujigaki

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引用次数: 0

摘要

一名 42 岁的女性出现肌肉无力和低血钾性远端肾小管酸中毒（dRTA）。检查发现，她同时患有斯约格伦综合征（SS）和桥本氏甲状腺炎，导致低钾血症性远端肾小管酸中毒。肾活检显示，灶性肾小管间质性肾炎（TIN）提示与SS相关的肾脏受累，同时伴有明显的缺血性肾小球病变和符合低钾血症肾病的肾小管病变。补充钾后，肾小管损伤指标和低碳血症迅速改善，这表明低钾血症导致了近端肾小管损伤。该病例强调了同时存在 TIN 和低钾血症肾病所带来的诊断挑战，因为这可能会掩盖 SS-TIN 继发的低钾血症 dRTA 患者的低钾血症肾病。

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Coexistence of Sjögren's Syndrome-associated Interstitial Nephritis and Hypokalemic Nephropathy in a Patient with Distal Renal Tubular Acidosis.

A 42-year-old woman presented with muscle weakness and hypokalemic distal renal tubular acidosis (dRTA). Investigations revealed concurrent Sjögren's syndrome (SS) and Hashimoto's thyroiditis contributing to hypokalemic dRTA. A renal biopsy revealed focal tubulointerstitial nephritis (TIN) suggestive of SS-related renal involvement, along with distinctive ischemic glomerular changes and tubular alterations consistent with hypokalemic nephropathy. Rapid improvement in tubular injury markers and hypobicarbonemia followed potassium supplementation, suggesting that hypokalemia contributed to proximal tubular injury. This case underscores the diagnostic challenge posed by the simultaneous presence of TIN and hypokalemic nephropathy, potentially masking hypokalemic nephropathy in patients with hypokalemic dRTA secondary to SS-TIN.

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来源期刊

Internal Medicine 医学-医学：内科

CiteScore

1.90

自引率

8.30%

发文量

审稿时长

2.2 months

期刊介绍： Internal Medicine is an open-access online only journal published monthly by the Japanese Society of Internal Medicine. Articles must be prepared in accordance with "The Uniform Requirements for Manuscripts Submitted to Biomedical Journals (see Annals of Internal Medicine 108: 258-265, 1988), must be contributed solely to the Internal Medicine, and become the property of the Japanese Society of Internal Medicine. Statements contained therein are the responsibility of the author(s). The Society reserves copyright and renewal on all published material and such material may not be reproduced in any form without the written permission of the Society.