Case Report: Osteomalacia Secondary to Mixed Renal Tubular Acidosis from Primary Sjogren's Syndrome

Abstract

Sjogren's syndrome is a type of autoimmune rheumatic disease that involves chronic inflammation of various organs, particularly the exocrine glands. Additionally, it can cause symptoms in other systems, such as the skin, joints, lungs, kidneys, blood vessels, and nerves.
In this report, we present a case of a 47-year-old female who presented with generalized body pain for the past 4 months, along with weakness in the arms and legs. Bone density testing reported low T-score in osteoporotic range. She was treated with alendronate; however, her symptoms got worse. She was referred to a rheumatologist. Blood tests revealed non-anion gap metabolic acidosis and multiple electrolyte imbalance, including low serum potassium and phosphate. Urine analysis showed protein, potassium, and phosphate loss. Serum testing for autoimmune panels showed positive for anti-SSA and anti-SSB antibodies, along with a Schirmer's test indicating decreased tear production. Therefore, the diagnosis of generalized bone pain due to osteomalacia secondary to mixed renal tubular acidosis from primary Sjogren's syndrome.