Renal Tubular Acidosis in Sjogren's Syndrome: A Case Series

Renal Tubular Acidosis in Sjogren's Syndrome: A Case Series
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DOI:
10.1159/000365199
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发表时间:
2014-01-01
影响因子:
4.2
通讯作者:
Dakshinamurty, Kaligotla Venkata
Dakshinamurty, Kaligotla Venkata
中科院分区:
医学3区
文献类型:
--
作者:
Ram, Rapur;Swarnalatha, Gudithi;Dakshinamurty, Kaligotla Venkata

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背景:干燥综合征患者远端和近端肾小管酸中毒(RTA)的确切发生率尚不清楚。干燥综合征的其他特征,如多尿,肾小球表现,家族发生和怀孕并没有广泛报道。目的是前瞻性研究干燥综合征远端和近端RTA的临床特征和结局,并报告干燥综合征的其他肾脏表现。方法:本研究是一个前瞻性的连续病例系列的患者谁提出的历史提示RTA和干燥综合征。所有患者均随访1年。RTA的诊断是通过碳酸氢盐的排泄分数。干燥综合征的诊断是根据美国-欧洲分类系统[由Tzioufas和Vouloulis修改:Best Pract Res Clin Rheumol 2007; 21:989-1010]。结果:在此期间确诊的RTA患者总数为149例。干燥综合征占RTA患者的34.8%(52/149)。重要症状和实验室参数为23例(44.2%)的口腔和眼部症状、12例(23%)的龋齿、47例(90.3%)的身体疼痛、平均血清pH值7.202 +/- 0.03、平均血清碳酸氢盐14.03 +/- 1.66 mmol/l和平均尿液pH值7.125 +/- 0.54。远端RTA 30例(57.6%),近端RTA 22例(42.3%)。结论:本研究的临床意义是RTA是干燥综合征的一个共同特征。如果不是由于口腔和眼部症状,可能会错过。本研究也是唯一一项随访1年的研究。(C)2014 S. Karger AG,巴塞尔
Background: The exact frequency of distal and proximal renal tubular acidosis (RTA) in Sjogren's syndrome is unknown. Other features of Sjogren's syndrome like polyuria, glomerular manifestations, familial occurrence and pregnancy are not widely reported. The aim was to prospectively study the clinical features and outcome of distal and proximal RTA in Sjogren's syndrome and also report on other renal manifestations of Sjogren's syndrome. Methods: The present study is a prospective consecutive case series of patients who presented with a history suggestive of RTA and Sjogren's syndrome. All patients were followed for 1 year. The diagnosis of RTA was by fractional excretion of bicarbonate. The diagnosis of Sjogren's syndrome was according to the American-European classification system [modified by Tzioufas and Voulgarelis: Best Pract Res Clin Rheumatol 2007; 21: 989-1010]. Results: The total number of RTA patients diagnosed during this period was 149. Sjogren's syndrome accounted for 34.8% (52 of 149) of RTA patients. The important symptoms and laboratory parameters were oral and ocular symptoms in 23 (44.2%), dental caries in 12 (23%), body pains in 47 (90.3%), mean serum pH 7.202 +/- 0.03, mean serum bicarbonate, 14.03 +/- 1.66 mmol/l, and mean urine pH, 7.125 +/- 0.54. There were 30 (57.6%) patients with distal RTA and 22 (42.3%) patients with proximal RTA. Conclusions: The clinical implication of the present study is that RTA is a common feature of Sjogren's syndrome. It may be missed if the presentation is not due to oral and ocular symptoms. The present study is also the only one with a 1-year follow-up. (C) 2014 S. Karger AG, Basel