Clin Osteol 2008; 13(2): 71-75

Osteomalacia as the first sign of Sjogren's syndromeNews

H. Ciferská, P. Horák, M. Skácelová, A. Smržová, J. Zadražil

At the department of rheumatology, a 44-year-old female was examined with a long history of musculoskeletal pain and significant loss of bone mineral density. The laboratory findings showed higher levels of the bone fraction of alkaline phosphatase and normal calci­ um levels. Bone histomorphometry revealed the presence of osteomalacia. Subsequently, the patient was found to have renal tubular acidosis, increased renal bicarbonate loss, glycosuria and aminoaciduria. Some time later, the diagnosis of primary Sjogren's syndro­ me (SS) was made, with fully manifested clinical and immunological findings. Secondary osteomalacia diagnosed in the patient was a rare manifestation of Fanconi syndrome. The syndrome is a less common manifestation of SS but occasionally it precedes the typi­ cal glandular manifestation of SS. Sjogren's syndrome is an autoimmune disease, mostly affecting exocrine glands and often associa­ ted with other autoimmune diseases. Its manifestations vary in severity, from isolated sicca syndrome to severe systemic manifestations in the form of vasculitis and pulmonary and renal involvement. Renal tubular acidosis, either latent or manifested, caused by auto­ immune tubulointerstitial nephritis is one of the less frequent extraglandular manifestations of the disease. In Sjogren's syndrome pa­ tients, this manifestation should be considered to prevent development of

Keywords: Fanconi syndrome, Sjogren's syndrome, osteomalacia, osteoporosis

Published: December 11, 2008  Show citation