Rapid Improvement of Osteomalacia by Treatment in a Case with Sjögren's Syndrome, Rheumatoid Arthritis and Renal Tubular Acidosis Type 1

Makoto OKADA; Kimihiro SUZUKI; Toshihiko HIDAKA; Tadashi SHINOHARA; Koji KATAHARADA; Mitsuyo MATSUMOTO; Kunio TAKADA; Fumitaka OHSUZU

doi:10.2169/internalmedicine.40.829

Makoto OKADA, Kimihiro SUZUKI, Toshihiko HIDAKA, Tadashi SHINOHARA, Koji KATAHARADA, Mitsuyo MATSUMOTO, Kunio TAKADA, Fumitaka OHSUZU

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Makoto OKADA
the First Department of Internal Medicine, National Defense Medical College
Kimihiro SUZUKI
the First Department of Internal Medicine, National Defense Medical College
Toshihiko HIDAKA
the First Department of Internal Medicine, National Defense Medical College
Tadashi SHINOHARA
the First Department of Internal Medicine, National Defense Medical College
Koji KATAHARADA
the First Department of Internal Medicine, National Defense Medical College
Mitsuyo MATSUMOTO
the First Department of Internal Medicine, National Defense Medical College
Kunio TAKADA
the First Department of Internal Medicine, National Defense Medical College
Fumitaka OHSUZU
the First Department of Internal Medicine, National Defense Medical College

Keywords: tubulointerstitial nephritis, hyperchloremic metabolic acidosis, bone mineral density (BMD), dual energy X-ray absorptiometry (DEXA), Shohl liquid, osteoporosis

JOURNAL FREE ACCESS

2001 Volume 40 Issue 8 Pages 829-832

DOI https://doi.org/10.2169/internalmedicine.40.829

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Abstract

We present here a case of Sjögren's syndrome (SjS) with osteomalacia based on renal tubular acidosis type 1 (RTA1). A 53-year-old woman, diagnosed as having rheumatoid arthritis (RA) at the age of 33, was admitted to our hospital because of sicca complex, fatigability and worsening general aching. The activity of RA had been low, but it was complicated by SjS, RTA-1 and remarkable osteomalacia. Acidosis was corrected by alkali supplement therapy. By treatment with a regimen consisting of alfacalcidol, calcium L-aspartate, elcatonin and ipriflavone, her bone mineral density (BMD) was remarkably improved within months and the generalized aching gradually diminished.
(Internal Medicine 40: 829-832, 2001)

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