Primary Sjögren’s syndrome complicated by renal tubular acidosis and acute bilateral uveitis: a case report and literature review

Abstract

Primary Sjögren’s syndrome (pSS) is an autoimmune disease that can cause gland dysfunction, leading to dry mouth and dry eyes as the main clinical manifestations. In addition, pSS may affect the gastrointestinal tract, skin, lungs, kidneys, nervous system, eyes, and other organs. We herein report a case involving a 38-year-old woman who presented with a 6-month history of dry mouth and eyes and a 10-day history of fever. She was diagnosed with pSS complicated by renal tubular acidosis, and her symptoms were alleviated after treatment with prednisone and mycophenolate. However, shortly after discontinuation of these medications outside the hospital, she experienced acute vision loss in both eyes. Bilateral uveitis secondary to pSS was diagnosed with the assistance of the Department of Ophthalmology, and the patient was treated with systemic steroids and topical ocular symptomatic therapy. After treatment, her systemic symptoms were relieved and her vision recovered. Although pSS complicated by renal tubular acidosis and uveitis is rare, it can lead to serious consequences such as abnormal renal function, visual impairment, and even blindness if not promptly treated. Steroid and immunosuppressive therapies are effective, and ophthalmology consultation should be performed if necessary for diagnosis and management.