Litiasis urinaria múltiple y nefrocalcinosis secundaria a síndrome de sjögren primario

Resumen

Una paciente de 39 años de edad diagnosticada de síndrome de Sjögren primario (SSp) desarrolla litiasis reno-ureteral múltiple y nefrocalcinosis bilateral secundaria a acidosis tubular renal distal (ATRd), hipercalciuria e hipocitraturia. Resultan positivos los anticuerpos ANA moteado 1/320, ENA totales, Anti-SSA/Ro 52, Anti-SSA/Ro 60 y Anti-SSB-La. Los cálculos son tratados con litotricia extracorpórea por ondas de choque con resultado satisfactorio, correspondiendo su composición a fosfato cálcico y oxalato cálcico. Los trastornos metabólicos son corregidos con la administración de citrato potásico e hidroclorotiazida. Después de dos años de seguimiento, la paciente no ha recurrido de la litiasis y mantiene niveles normales de citrato y calcio en orina de 24 horas.

Abstract

A 39 year old women with a primary Sjögren syndrome (pSS) had bilateral and multiple nephrolithiasis and nephrocalcinosis due to distal renal tubular acidosis (dRTA), hypercalciuria and hypocitraturia. She had in serum positive antinuclear antibodies with mottled pattern 1/320, totals ENA, Anti-SSA/Ro 52, Anti-SSA/Ro 60 and Anti-SSB-La antibodies. Stones were removed with extracorporeal shock wave lithotripsy satisfactory and were composed of calcium phosphate and calcium oxalate. Metabolic abnormalities were resolved with potassium citrate and hydrochlorothiazide. At two years of follow-up, the patient hadn’t stone recurrence and had normal 24-hour urinary levels of citrate and calcium.