Background Extraglandular manifestations in primary Sjögren's syndrome (pSS) are frequent and may include renal involvement. This is one of the systemic involvement that marks pSS prognosis.
Objectives The goal of this work is to study the demographic, clinical, serologic features and outcomes of Tunisian patients with pSS and renal involvement.
Methods It is a single-center retrospective study including all the cases of pSS diagnosed since 1998 until 2011 in Internal Medicine Department from Tunis in Tunisia. All the patients fulfilled the 2002 American-European Consensus Group (AECG) criteria for pSS.
Results We examined the hospital records and laboratory findings of 31 patients with pSS. Among these patients, renal impairment was observed in 9.6% of cases, all women. It was noted in 3 cases tubulo-interstitial nephritis. They were revealed by hypokalemic rhabdomyolysis in 2 patients and bone pains in one patient.
Further explorations revealed bilateral nephrocalcinosis and moderate kidney failure in one case and osteomalacia in another case. All these patients have distal tubular acidosis.
All these patients have received symptomatic treatment (sodium bicarbonate, potassium chlorides). Vitamin D and Calcium was prescribed for the patient with osteomalacia and corticosteroids was given to the patient with nephroclcinosis and moderate kidney failure.
The evolution was marked by the regression of rhabdomylysis, and osteomalacia and the improvement of kidney function.
Conclusions Tubulo-inerstitial nephritis is the most frequent kidney involvement during pSS. It is rarely an inaugural manifestation of the disease. However the presence of a hypocitraturie in the presence of a renal lithiasis, hypokalemia and even rhabdomyolyis or osteomalacia must evoke distal tubular acidosis. Its early diagnosis allows to adapt the best therapy and avoid the evolution to chronic renal failure.
Disclosure of Interest None declared
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