Korean J Nephrol.  2007 Sep;26(5):619-624.

A Case of Mixed Type Renal Tubular Acidosis with Primary Sjogren`s Syndrome

Affiliations
  • 1Department of Internal Medicine, Hallym Kidney Research Institute College of Medicine, Hallym University, Seoul, Korea. km2071@unitel.co.kr

Abstract

56-year old woman was hospitalized for severe weakness and generalized bone pain, so she was immediately evaluated for the multiple bone lesions under the impression of malignancy with bone metastasis at the department of oncology. No underlying malignancy was found and the patient was referred to the division of nephrology, where patient was diagnosed as mixed type renal tubular acidosis (RTA) with clinical features of both type 1 and type 2 RTA. Type 2 RTA was diagnosed by high fractional excretion of bicarbonate over 15% and multiple bone lesions, and type 1 RTA was diagnosed by the presence of nephrocalcinosis and sustained high urine pH over 7.0 in spite of severe metabolic acidosis (pH <7.2) with low serum bicarbonate level. She also had findings characteristic of primary Sjogrens syndrome. The treatment started with sodium bicarbonate, vitamin D, calcium and analgesics. In the following seven months, acidosis and symptoms such as bone pain were improved gradually.

Keyword

Renal tubular acidosis; Sjosyndrome; Bone

MeSH Terms

Acidosis
Acidosis, Renal Tubular*
Analgesics
Calcium
Female
Humans
Hydrogen-Ion Concentration
Middle Aged
Neoplasm Metastasis
Nephrocalcinosis
Nephrology
Sjogren's Syndrome
Sodium Bicarbonate
Vitamin D
Analgesics
Calcium
Sodium Bicarbonate
Vitamin D
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