TY - JOUR T1 - Primary Sjögren’s syndrome manifesting as sclerotic metabolic bone disease JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2020-237987 VL - 14 IS - 1 SP - e237987 AU - Hiya Boro AU - Alpesh Goyal AU - Shailendra Singh Naik AU - Nikhil Tandon Y1 - 2021/01/01 UR - http://casereports.bmj.com/content/14/1/e237987.abstract N2 - Primary Sjögren’s syndrome (pSS) is a chronic slowly progressive autoimmune disease characterised by lymphocytic infiltration of salivary and lacrimal glands with varying degree of systemic involvement. Renal involvement, a recognised extraglandular manifestation of pSS, is commonly related to tubular dysfunction and generally manifests as distal renal tubular acidosis (RTA), proximal RTA, tubular proteinuria and nephrogenic diabetes insipidus. Untreated long-standing RTA is known to cause metabolic bone disease. Here, we present the report of a patient with sclerotic metabolic bone disease related to pSS with combined distal and proximal RTA and negative workup for other causes of sclerotic bone disease. A significant clinical and biochemical improvement, including recovery of proximal tubular dysfunction, was noted with alkali therapy. This case suggests the need to consider pSS in the diagnostic algorithm of a patient presenting with sclerotic bone disease. ER -