Abstract: PO1119
From Hypokalemia to Sjögren Syndrome: What a Twist!
Session Information
- Salt, Potassium, and Water Balance: Clinical
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid, Electrolyte, and Acid-Base Disorders
- 902 Fluid, Electrolyte, and Acid-Base Disorders: Clinical
Authors
- Pabon-Vazquez, Elizabeth, Mayaguez Medical Center, Mayaguez, Puerto Rico
- Rivera Sepulveda, Jose, Mayaguez Medical Center, Mayaguez, Puerto Rico
Introduction
Potassium disorders are one of the many serious conditions that could attempt against a patient’s life. Understanding the clinical presentation, diagnosis, management, and treatment of hypokalemia is fundamental for the development of successful clinical physician. In addition, being aware of the associations between electrolyte disturbances and rheumatologic conditions increases the benefits of correctly treating and educating patients.
Case Description
This is the case of a 24 y/o female patient, G1P2A0, with a past medical history of hypoglycemia and hypokalemia since pregnancy with twins. Patient presented to emergency department with shortness of breath, general malaise, muscle weakness, and unable to ambulate. Physical examination was remarkable for proximal muscle weakness, diminished reflexes with intact sensation. Laboratory bloodwork reported positive mycoplasma pneumonia infection, normal anion gap metabolic acidosis with severe bicarbonate and potassium deficiency with EKG changes as ST depression with flattening of T wave and U-wave. Urinalysis had a basic pH with positive urine anion gap. Findings were suggestive of renal tubular acidosis (RTA). In addition, patient reported several episodes of nephrolithiasis during childhood, supporting distal RTA. Hypokalemia history and renal findings trigger were unknown. However, due to association of RTA type 1 and autoimmune disease, workup was performed. Rheumatoid factor, ANA screen, aldolase and SS-A/Ro antibody were positive consistent with Sjogren syndrome diagnosis. There are only a few documented cases. After discussing results with patient, she reported the daily use of artificial tears due to xerophthalmia. She did not report it sooner because, she considered the fact irrelevant to her clinical presentation.
Discussion
Sjogren syndrome is a chronic autoimmune inflammatory disease that could negatively affect the patient’s quality of life. Triggers have not been completely identified due to multifactorial involvement and diversity of clinical manifestation. In Puerto Rico, there is a small population currently diagnosed with the syndrome. However, research studies of epidemiological characteristics or clinical profile in Puerto Rico are still ongoing.