title: [Distal renal tubular acidosis as a cause of osteomalacia in a patient with primary Sjögren's syndrome].
abstract: BACKGROUND
  One half of the patients with primary Sjögren's syndrome has extraglandular manifestations, including renal involvement. The most frequent renal lesion is tubulo-interstitial nephritis, which manifests clinically as distal tubular acidosis and may result in the development of osteomalacia.
  
  
  METHODS
  In a 29-year-old female patient, with bilateral nephrolithiasis, the diagnosis of primary Sjögren's syndrome, tubulo-interstitial nephritis, distal renal tubular acidosis, and hypokalemia were established. She was treated for hypokalemia. Two years later she developed bone pains and muscle weakness, she wasn't able to walk, her proximal muscles and pelvic bones were painful, with radiological signs of pelvic bones osteopenia and pubic bones fractures. The diagnosis of osteomalacia was established and the treatment started with Schol's solution, vitamin D and calcium. In the following two months, acidosis was corrected, and the patient started walking.
  
  
  CONCLUSIONS
  In our patient with primary Sjögren's syndrome and interstitial nephritis, osteomalacia was a result of the long time decompensate acidosis, so the correction of acidosis, and the supplementation of vitamin D and calcium were the integral part of the therapy.
authors.affiliation: Vojnomedicinska akademija, Klinika za reumatologiju i klinicku imunologiju, Beograd, Srbija i Crna Gora. jovelic@EUnet.yu
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Jovelić
authors.forename: Dusan
authors.initials: D
authors.lastname: Stefanović
mesh_terms: D000141:Acidosis, Renal Tubular / Q000150:complications*; D000328:Adult; D005260:Female; D006801:Humans; D009395:Nephritis, Interstitial / Q000150:complications; D009397:Nephrocalcinosis / Q000150:complications; D010018:Osteomalacia / Q000209:etiology*; D012859:Sjogren's Syndrome / Q000150:complications*