Fractures: The opening batsmen of an autoimmune disease

Abstract

Renal involvement is a well-known extraglandular manifestation of primary Sjögren's syndrome (pSS). Most of the manifestations are related to tubular dysfunction. Metabolic bone disease rarely occurs as the first manifestation of a renal tubule disorder due to pSS. Here, we present a 28-year-old female patient whose first presentation of pSS was with multiple skeletal fractures caused by renal tubular dysfunction. Clinicians should always search for the evidence for Sjögren's syndrome in adult patients with unexplained osteomalacia and renal tubular acidosis, even in the absence of sicca syndrome.

Keywords

• osteomalacia
• renal tubular acidosis
• sjögren's
• tubular dysfunction