International Journal of Diabetes & its Complications
ISSN: 2573-8895 | DOI: 10.64030/2573-8895
Zhi Yang, Xi Chen, Chao Chen, Jiajia Hao, Feili Liu, Shihui Lei, Zibo Su, Mian Xie, Xiaobing Chen, Qiulin Lin and Yurong Jiang
Background: This case report highlights the diagnostic challenge of unexplained fatigue and recurrent hypokalemia, emphasizing the importance of considering autoimmune etiologies, specifically Sjögren’s syndrome complicated by renal tubular acidosis, in such presentations. While this association is documented, cases presenting primarily with persistent fatigue and electrolyte disturbances underscore the need for a broad differential diagnosis.
Case Presentation: A 55-year-old female presented with a two-month history of progressive fatigue and intermittent muscle twitching. Initial evaluations revealed recurrent hypokalemia, which improved only transiently with supplementation. Comprehensive workup, including positive anti-SSA/SSB antibodies and findings suggestive of renal potassium wasting, led to the diagnosis of Sjögren’s syndrome with associated renal tubular acidosis. Treatment involved potassium correction, hydroxychloroquine, and corticosteroids. At discharge and follow-up, her fatigue resolved, potassium levels normalized, and no symptom recurrence was observed.
Conclusions: This case illustrates that Sjögren’s syndrome can manifest with significant metabolic disturbances like hypokalemic renal tubular acidosis, even when classic sicca symptoms are subtle. It underscores the necessity of a thorough, interdisciplinary diagnostic approach for patients with unexplained fatigue and electrolyte imbalances to identify underlying autoimmune disorders, thereby enabling targeted therapy and improving outcomes.