In the December 2011 issue of the American Journal of Kidney Diseases, Piccoli et al describe a case of renal colic in a quiz

Distal renal tubular acidosis (RTA) in this case lead to renal colic and nephrocalcinosis. The RTA was due to Sjogren’s Syndrome (SS). SS has been associated with other kidney diseases as well. Try these questions out to test your knowledge of SS and kidney disease.

1. A 45-year-old woman was recently found to have a positive schrirmer test. She has a past history of chronic pancreatitis. She is referred to your clinic for chronic kidney disease with 6 years of progressively declining GFR. Her serum creatinine is currently 1.8mg/dL and her eGFR is 34 ml/min/1.73 m2. Her urinalysis is negative for or proteinuria, and she has a bland urinary sediment. What diagnosis is suggested by this biopsy?

Image courtesy of Dr. Helmut Rennke

A. Chronic thrombotic microangiopathy
B. Chronic tubulo-interstitial nephritis
C. Focal segmental glomerular sclerosis (FSGS)
D. Chronic immune complex associated disease

2. A 56-year-old man with no past medical history presents with sudden onset of edema, hypoalbuminemia of 1.2g/dL, and 24-hour proteinuria of 12gm. SS antibody titers, schrirmer test, and urinary CD80 are all positive. What is the most likely diagnosis from this kidney biopsy?

A. Focal segmental glomerular sclerosis (FSGS)
B. Minimal change disease (MCD)
C. Membranous glomerulopathy
D. Tubulo-interstitial nephritis

3. As seen in this figure, what is the most common glomerular disease in SS?

A. Focal segmental glomerular sclerosis (FSGS)
B. Minimal change disease (MCD)
C. Membranous glomerulopathy
D. Mesangioproliferative glomerulonephritis
E. Membranoproliferative glomerulonephritis

To see the answers click here