ACQUIRED NEPHROGENIC DIABETES-INSIPIDUS SECONDARY TO DISTAL RENAL TUBULAR-ACIDOSIS AND NEPHROCALCINOSIS ASSOCIATED WITH SJOGRENS-SYNDROME

A 52-year-old woman was referred to our hospital because of 16-year history of polyuria and polydipsia. Hyposthenuria, hyperchloremic metabolic acidosis and the inabilities to acidify the urine after acid-loading test and to concentrate the urine in responses to water-deprivation and antidiuretic hormone administration allowed us to diagnose renal tubular acidosis and nephrogenic diabetes insipidus. Radiographic examinations revealed bilateral nephrocalcinosis. The patient was also found to have clinical and laboratory findings characteristic for Sjogren's syndrome. Thus the longstanding, poorly monitored distal renal tubular acidosis associated with Sjogrens syndrome was considered to result in very rare renal complications nephrocalcinosis and nephrogenic diabetes insipidus. In patients with renal tubular acidosis and/or nephrogenic diabetes insipidus of unknown etiology, therefore, Sjogren's syndrome should be considered as one of primary disorders.