This case highlights the importance of an early detection and physiology-based approach to dRTA. Accurate characterization of this condition is pivotal to uncover an underlying disease, tailor a specific therapy, and prevent further renal function decline. Episodes of symptomatic hypokalemia could be a clue for diagnosis and should be carefully addressed to prevent life-threatening complications. Evaluating the renal response to immunomodulatory therapy in SS is of paramount interest as it can lead to a progressive decline in renal function.
AG: Anion gap; CA: Carbonic anhydrase; CKD: Chronic kidney disease; Cr: Creatinine; dRTA: Distal renal tubular acidosis; eGFR: Estimated glomerular filtration rate; HCQ: Hydroxychloroquine; IgG: Immunoglobulin G; MDRD: Modification of Diet in Renal Disease; SS: Sjögren's syndrome; TIN: Tubulointerstitial nephritis; UAG: Urine anion gap
The authors express their gratitude to Dr. David Brink and the Pathology Department at St. Louis University School of Medicine for assistance with clinical pathological images.
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J Med Case Reports. 2019;13(103) © 2019 BioMed Central, Ltd.