Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\28509074
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 CEN+Case+Rep
2012 ; 1
(2
): 123-127
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Osteomalacia secondary to renal tubular acidosis due to Sjögren s syndrome: a
case report and review of the literature
#MMPMID28509074
Nagae H
; Noguchi Y
; Ogata S
; Ogata C
; Matsui R
; Shimomura Y
; Katafuchi R
CEN Case Rep
2012[Nov]; 1
(2
): 123-127
PMID28509074
show ga
A 43-year-old woman was admitted to our hospital because of generalized bone
pain. Arterial blood gas showed pH 7.266, HCO(3)(-) 13.5 mEq/l, and anion gap
(AG) 12. Since her urine pH was 7.0 despite metabolic acidosis with normal AG, we
diagnosed distal renal tubular acidosis (RTA). Serum phosphate was 2.5 mg/dl, the
level of ?2 microglobulin was 41100 ?g/l, and aminoaciduria was present. These
results indicated proximal tubular dysfunction. The radiograph showed
pseudofracture in the pubic bone, indicating osteomalacia. Bone scintigram showed
abnormal accumulations of 99mTc-HMDP in multiple joints. Then, her generalized
bone pain was considered to be a symptom of osteomalacia. Despite the absence of
overt Sicca syndrome, the evaluation of Sjögren's syndrome (SjS) as a cause of
distal RTA was performed. Antibodies to the SS-A level was 127U/ml. Tear break-up
time was 3 s bilaterally and salivary gland scintigraphy showed low uptake of
99mTc in the submandibular glands and the parotids. Thus, we diagnosed SjS
finally. Gallium scintigraphy showed mild abnormal uptake in bilateral kidneys,
suggesting acute tubulointerstitial nephritis. After treatment with prednisolone,
alfacalcidol, and sodium bicarbonate, bone pain was remarkably relieved.
Additionally, aminoaciduria disappeared and the level of ?2 microglobulin
decreased. We speculated that the coincidence of proximal tubular dysfunction and
distal RTA cause a severe manifestation of osteomalacia.