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Urinary acidification was impaired in 6 of 12 patients with Sjogren's syndrome (SS) studied before and during the administration of ammonium chloride. Renal tubular acidosis was overt in 3 patients and subclinical in 2. The sixth patient had glomerulonephritis. Precipitating antibodies to tissue antigens were studied in 70 patients with SS. The group with renal disease had the greatest reactivity, and the only reactivity to heat denatured DNA. None of the 70 patients reacted with native DNA, and only one with nucleoprotein.

1. Gastro-intestinal absorption of calcium was studied in man by the measurement of forearm radioactivity in a large-volume liquid scintillation counter following separate oral and intravenous doses of 47CaCl2. From the ratio of the percentages of total radioactivity appearing in the forearm following these separate determinations the fractional absorption of calcium was estimated. 2. Changes of forearm radioactivity with time following the administration of this isotope were studied; evidence is presented that the radioactivity in the forearm at 4 h after administration of the isotope gives a valid assessment of fractional calcium absorption. 3. Fractional calcium absorption determined by this technique correlated well with the net calcium absorption as determined from stool radioactivity after oral administration of isotope. 4. In normal subjects it was shown that fractional calcium absorption measured by this technique varies inversely with the stable calcium load and that the absolute amount of calcium absorbed from given loads increases with the size of the load in the range 20–1000 mg calcium. 5. Gastro-intestinal calcium absorption was measured at various oral calcium loads in a group of fifteen patients with recurrent calcium-containing renal stones. All the patients were normocalcaemic; some had hypercalciuria. In the patients with hypercalciuria, calcium absorption, fractional and absolute, was significantly increased at all calcium loads as compared to that of patients with normal urinary calcium. 6. It is concluded that hyperabsorption of calcium from the gastro-intestinal tract plays a crucial role in the aetiology of hypercalciuria, probably by causing an increase in the renal filtered calcium load.

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