Case A 28-year-old female with a history of hypothyroidism, Sjögren’s Syndrome, and systemic lupus erythematosus (SLE) was presented. She had complained of generalized weakness, muscle pain, nausea, vomiting, and anorexia Physical examination was unremarkable Diagnostic Tests Laboratory tests showed following readings: Hypokalemia at 1.6 mmol/l Non-anion metabolic acidosis with HCO3of 11 mmol/l Random urine pH of 7.0 Urine anion gap of 8 mmol/l CT scan of the abdomen showed bilateral nephrocalcinosis Diagnosis A diagnosis of Type 1 Renal Tubular Acidosis (RTA) was made, secondary to Sjögren’s Syndrome. Treatment She was started with citric acid potassium citrate regimen, with escalating dosage to maximum dosage of 60mEq daily and potassium chloride over 5 years.
The regimen did not improve her condition and generalized weakness and cardiac arrhythmias persisted. Sodium bicarbonate…
