Renal and pancreatic calcification in rheumatoid arthritis with Sjögren's syndrome

We describe a female patient who developed seropositive rheumatoid arthritis (RA) at the age of 12 years. After 10 years her disease was complicated by Sjögren's syndrome (SS) and distal (type 1) renal tubular acidosis (RTA). Seven years later she was noted to have nephrocalcinosis. At the age of 32, investigation of a short history of weight loss and abdominal pain revealed a benign gastric ulcer and chronic calcific pancreatitis. We believe she is the first patient with RA and SS in whom complicating renal and pancreatic calcification have been reported. Her case emphasizes the good prognosis of type 1 RTA in SS and suggests that pancreatic involvement may be more common than clinically apparent.