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Lee, Lee, Park, Park, Kim, Lee, and Park: A Case of Type 1 Renal Tubular Acidosis and Osteomalacia in a Patient with Sjögren's Syndrome
Case Report
Journal of Rheumatic Diseases

Journal of Rheumatic Diseases 2012; 19(4): 220-224.

Published online: 31 August 2012

DOI: https://doi.org/10.4078/jrd.2012.19.4.220

A Case of Type 1 Renal Tubular Acidosis and Osteomalacia in a Patient with Sjögren's Syndrome

Ho-Jun Lee, Sung-Ji Lee, Seong-Chang Park, Dong-Jin Park, Tae-Jong Kim, Shin-Seok Lee, Yong-Wook Park

Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Korea.

Corresponding to: Yong-Wook Park, Department of Rheumatology, Chonnam National University Medical School and Hospital, 42, Jebong-ro, Dong-gu, Gwangju 501-757, Korea. parkyw@jnu.ac.kr

Received 21 July 2011       Revised 21 September 2011       Accepted 12 October 2011

Copyright © 2012 by The Korean College of Rheumatology

(free-access):

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Sjögren's syndrome is a chronic autoimmune disease characterized by decreased function of the lacrimal and salivary glands. In addition, many other organs can be involved in patients with Sjögren's syndrome. Overt or latent renal tubular acidosis is an uncommon extraglandular manifestation in Sjögren's syndrome, and osteomalacia is a rare complication of renal tubular acidosis. It has been rarely reported that osteomalacia is associated with distal renal tubular acidosis in patients with Sjögren's syndrome. We report a case of a 34-year-old female patient who was initially presented with muscle weakness in both lower extremities. The patient was then diagnosed with Sjögren's syndrome complicated by osteomalacia and renal tubular acidosis

Keywords: Sjögren's syndrome, Renal tubular acidosis, Osteomalacia

Figures and Tables

Figure 1
Kidney-ureter-bladder (KUB) radiograph demonstrating multiple calculi in both kidney.
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Figure 2
Pseudofracture and decreased bone mineral density in a patient with Sjögren's syndrome and type 1 renal tubular acidosis. (A) Hip X-ray shows insufficiency fracture or pseudofracture of the right femoral neck (black arrows). (B) Bone mineral density examination shows markedly decreased T-score and Z-score in both femoral bones.
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Figure 3
Salivary gland scan shows decreased radioisotope uptakes in both parotid and submandibular glands.
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Figure 4
Salivary gland biopsy shows focal lymphocytic infiltration in minor salivary glands of lower lip (H & E stain, ×100).
jrd-19-220-g004

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