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MR Vol.10 No.3 indexに戻る
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MODERN RHEUMATOLOGY
Vol.10 No.3 |
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A case of Sjogren's syndrome complicated
by nephrogenic diabetes insipidus and renal tubular acidosis |
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| W. Hirose1, M. Kawagoe2 |
(1)Hirose Clinic, 2-14-7 Midori-cho, Tokorozawa,
Saitama, 359-1111, Japan
(2)Department of Medicine, Urawa Municipal Hospital, Saitama, Japan |
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| Abstract |
| Abstract We describe the case of a 46-year-old
woman with Sjogren's syndrome (SS) presenting with a 6-year history
of polyuria and polydipsia. Laboratory data revealed hyperchloremic
metabolic acidosis, a normal anion gap, and an inability to acidify
urine following an acid loading test and to concentrate the urine
in response to water deprivation and antidiuretic hormone administration.
Lymphocyte infiltration in the interstitium was found on renal biopsy.
These findings allowed us to diagnose distal renal tubular acidosis
(RTA) and nephrogenic diabetes insipidus (NDI). Steroid pulse therapy
resulted in normalization of the blood pH, but failed to remit the
inability to concentrate the urine. These observations suggest therapeutic
applications for RTA in SS, and that further investigation is required
to design a therapeutic strategy for NDI in SS. |
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| Key words |
| Key words Sjogren's syndrome ・ Nephrogenic
diabetes insipidus ・ Renal tubular acidosis ・ Steroid therapy |
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