肾小管酸中毒伴骨软化继发于干燥综合征1例并文献分析

Renal tubular acidosis associated with acquired hypophosphatemic osteomalacia in elderly women with primary Sjogren's syndrome:A case report and review of the literature

目的分析干燥综合征(Sjgren’s syndrome,SS)并发肾小管酸中毒伴骨软化症少见首发症状的特点。方法采用病例回顾方法讨论干燥综合征累及肾小管酸中毒伴骨软化的特点并结合文献复习。结果 Pubmed检索的10例患者均为女性,平均年龄47岁,首发症状均不同,多以(60%)骨痛和肢体无力起病,治疗上纠正酸中毒,中性磷对症治疗,系统性应用糖皮质激素被证明有效。结论肾小管酸中毒引起的骨软化症起病的患者极易误诊,这种少见表现应作为SS鉴别诊断之一。

Objective To analyzethecharacteristics of thehypophosphatemic osteomalacia associated with renal tubular acidosis（ RTA） in elderly women with primary Sjgren＇s syndrome（ SS）. Methods Retrospectivemethod was used to report a caseof RTA with SS. Theassociated literatures werereviewed. Results Ten cases of SS and RTA associated with osteomalacia had been reported in women,with a mean ageof 47 years old. Bonepain and weakness of theextremities werethefirst symptom in 60% of thecases. Anti-acidosis treatment,phosphorus treatment,and systemic useof corticosteroids werereported to beeffective.Conclusion Patients with osteomalacia dueto RTA areeasily misdiagnosed. It should bedifferentially diagnosed with SS.