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 hi story of polyuria and polydipsia. Hyposthenuria, hyperchloremic metabo lic acidosis and the inabilities to acidify the urine after acid-loadi ng 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 exam inations revealed bilateral nephrocalcinosis. The patient was also fou nd to have clinical and laboratory findings characteristic for Sjogren 's syndrome. Thus the longstanding, poorly monitored distal renal tubu lar acidosis associated with Sjogrens syndrome was considered to resul t in very rare renal complications nephrocalcinosis and nephrogenic di abetes insipidus. In patients with renal tubular acidosis and/or nephr ogenic diabetes insipidus of unknown etiology, therefore, Sjogren's sy ndrome should be considered as one of primary disorders.