Osteal Complications as First Manifestation in a Patient with Primary Sjögren's Syndrome and with Associated Distal Tubular Acidosis (Type 1) and Chronic Renal Insufficiency

: Renal affection is among the complications associated with the Sjögren's Syndrome. Tubulo‐interstitial nephritis constitutes the most frequent renal lesion and distal tubular acidosis (Type 1) is the most important clinical manifestation of this tubular dysfunction, although the occurrence of chronic renal insufficiency is not an uncommon finding in the presence of distal renal tubular acidosis. Osteomalacia is a clinical consequence of tubular acidosis caused by buffering of H+ in the bone. We present the case of a woman with osteal complication a year before being diagnosed with primary Sjögren's Syndrome and with distal tubular acidosis and renal insufficiency associated at diagnosis.