Display options
Cite
Kumar BV, Sivalingam M, Kumaran GS, et al. A Case of Renal Tubular Acidosis with Sjogren's Syndrome Showing Paradoxical Block of PTH Due to Severe Hypomagnesemia. Indian J Clin Biochem. 2016;32(4):496-499doi: 10.1007/s12291-016-0629-y.
Kumar, B. V., Sivalingam, M., Kumaran, G. S., & Balakrishnan, B. (2017). A Case of Renal Tubular Acidosis with Sjogren's Syndrome Showing Paradoxical Block of PTH Due to Severe Hypomagnesemia. Indian journal of clinical biochemistry : IJCB, 32(4), 496-499. https://doi.org/10.1007/s12291-016-0629-y
Kumar, B Vinodh, et al. "A Case of Renal Tubular Acidosis with Sjogren's Syndrome Showing Paradoxical Block of PTH Due to Severe Hypomagnesemia." Indian journal of clinical biochemistry : IJCB vol. 32,4 (2017): 496-499. doi: https://doi.org/10.1007/s12291-016-0629-y
Kumar BV, Sivalingam M, Kumaran GS, Balakrishnan B. A Case of Renal Tubular Acidosis with Sjogren's Syndrome Showing Paradoxical Block of PTH Due to Severe Hypomagnesemia. Indian J Clin Biochem. 2017 Oct;32(4):496-499. doi: 10.1007/s12291-016-0629-y. Epub 2016 Dec 18. PMID: 29062185; PMCID: PMC5634978.
Copy Download .nbib Format: NLM
Share it on

Indian J Clin Biochem. 2017 Oct;32(4):496-499. doi: 10.1007/s12291-016-0629-y. Epub 2016 Dec 18.

A Case of Renal Tubular Acidosis with Sjogren's Syndrome Showing Paradoxical Block of PTH Due to Severe Hypomagnesemia.

Indian journal of clinical biochemistry : IJCB

B Vinodh Kumar, M Sivalingam, G Shiva Kumaran, Balambal Balakrishnan

Affiliations

  1. Sundaram Medical Foundation, Dr. Rangarajan Memorial Hospital, 9C, IV Avenue, Shanthi Colony, Anna Nagar, Chennai, 600040 India.

PMID: 29062185 PMCID: PMC5634978 DOI: 10.1007/s12291-016-0629-y

Abstract

Distal renal tubular acidosis (RTA) manifests either as Complete/Classical form or Incomplete/Latent Form. Distal RTA causes normal anion gap metabolic acidosis and hypokalemia. Interstitial Nephritis is the most frequent renal manifestation of Sjogren's, which presents as Distal RTA in 25-40% of patients with Sjogren's syndrome. Magnesium deficiency is frequently associated with hypokalemia. Although serum calcium is the main physiological control for the secretion of parathyroid hormone (PTH) by the parathyroid, serum magnesium can also exert similar effects. While low levels of magnesium stimulate the secretion of PTH, very low serum concentrations tend to induce a paradoxical block of PTH release by activation of the alpha-subunits of heterotrimeric G-proteins. This mimicks the activation of calcium sensing receptor leading to inhibition of PTH secretion. Here we describe the case history of a 35-year-old lady who presented to our hospital with severe hypokalemia due to distal RTA and perhaps had a paradoxical block of PTH secretion in the setting of severe hypomagnesemia.

Keywords: Hypokalemia; Hypomagnesemia; Paradoxical block of PTH secretion; Renal tubular acidosis; Sjogren’s syndrome

References

  1. Lancet. 1973 Jun 16;1(7816):1389-90 - PubMed
  2. Curr Opin Nephrol Hypertens. 2002 Jul;11(4):403-10 - PubMed
  3. Proc Soc Exp Biol Med. 1981 Dec;168(3):382-8 - PubMed
  4. Am J Med. 1984 Jan;76(1):151-4 - PubMed
  5. J Clin Invest. 1973 Jan;52(1):153-60 - PubMed
  6. J Clin Invest. 1963 Mar;42:305-13 - PubMed
  7. Ann Intern Med. 1978 Feb;88(2):206-9 - PubMed
  8. Science. 1972 Aug 18;177(4049):606-8 - PubMed
  9. Ann Clin Biochem. 1999 Jul;36 ( Pt 4):408-22 - PubMed
  10. J Nephrol. 2002 Mar-Apr;15 Suppl 5:S142-50 - PubMed
  11. J Clin Endocrinol Metab. 1978 Oct;47(4):800-6 - PubMed
  12. Nephrol Dial Transplant. 2001 Dec;16(12):2328-36 - PubMed
  13. Clin Rheumatol. 1992 Jun;11(2):226-30 - PubMed
  14. Annu Rev Physiol. 1997;59:171-91 - PubMed
  15. Pediatr Nephrol. 2013 Aug;28(8):1195-206 - PubMed
  16. J Clin Endocrinol Metab. 1991 Nov;73(5):1067-72 - PubMed
  17. Kidney Int. 2001 Aug;60(2):436-45 - PubMed

Publication Types