When to hold 'em and when to fold 'em.
I have been one of the doubting Thomases on the board, and here is exactly why. Had I not critically and scientifically pursued this, I could have ended up prematurely crippled for life or dead. It's the old sicca versus Sjogrens.
"Alkali administration and glucocorticoid therapy result in improvement in the diminished lacrimal and salivary secretions in Sjogren's syndrome associated with dRTA. Without appropriate therapy, life-threatening systemic acidosis (plasma bicarbonate less than 5 mEq/L) may occur and require emergency intervention, including intravenous bicarbonate and potassium replacement and even respiratory support."
For any one interested in this topic, for any one with bone pain, with lumbar or flank pain and RIB PAIN....please read the article and insist on a BMP, Blood gases and a urine analysis for ph among other things.
http://www.medscape.com/viewarticle/410658_3
If I had not brought this problem to the attention of my doctors, I would still be diagnosed with plain old SjS, and the real issue of acidosis, regardless of cause, hereditary or autoimmune would not be properly treated. If it is autoimmune....I need something other than ivig to suppress the inflammation because my kidneys can not take it. If it is hereditary, it is simple bicarbonate and perhaps other electrolytes without all the toxic anti-inflammatory drugs and risks.
Huge difference.
Many things can cause Sicca or Sjogren's....basically dry eyes and mouth....by any name.
I meet ALL the criteria for SjS except SSA or SSB, and this includes a high ANA. I am less inclined to be concerned with Sjogren's than I am to correct the kidney defect that is causing acidosis, electrolyte imbalance, likely the arrhythmia, bone pain, broken bones, cramps etc and what appears to be Sjogren's, but perhaps is not, depends on the definition.
If treating dRTA corrects the sicca....than is it Sjogren's or is it actually the dRTA causing the issue, especially if you are sero-negative on ENA. HMMM.
Is there anyway you can post the article (if it's not too long)? Medscape seems to be only for health care prof. with a membership.
Thanks
Couldn't access that paper but here's another one that says of 60 SS patients in a study 27% were found to have kidney disfunction:
http://ndt.oxfordjournals.org/content/16/12/2328.abstract