A Case Report of Nearly Missed Renal Tubular Acidosis in the Setting of Sjögren's Syndrome.

The association of renal tubular acidosis (RTA) and Sjögren's syndrome (SS) has been well-documented in the literature previously but is often undiagnosed in clinical practice. In this case report, we present a case of a woman with distal RTA who presented with nausea, vomiting, and confusion. The case shows the diagnostic value of urine studies when evaluating a patient who has exaggerated and unexplained electrolyte losses and how this will change management. Recognizing the extra glandular manifestations of patients with SS is important for patient care to prevent delays in care and treatment.