{"paper_id":"2e485cf0-ceb4-44e8-9c65-8ed20fc44f4e","body_text":"Unraveling the Mystery of Recurrent Fatigue and Hypokalemia: A Case of Sjögren’s Syndrome Complicated by Renal Tubular Acidosis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Unraveling the Mystery of Recurrent Fatigue and Hypokalemia: A Case of Sjögren’s Syndrome Complicated by Renal Tubular Acidosis Zhi Yang, Xi Chen, Chao Chen, Jiajia Hao, Feili Liu, Shihui Lei, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7886127/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract A 55-year-old female presented with progressive fatigue over two months, accompanied by intermittent muscle twitching and hypokalemia. Initial evaluations revealed that potassium levels fluctuated between 3.01 mmol/L and 3.43 mmol/L, leading to potassium supplementation treatment. Although her symptoms improved temporarily, they persisted, requiring further investigations. Comprehensive assessments, including blood tests, CT scans, and specialized hormone tests, were conducted and initially suggested primary hyperaldosteronism; however, this was ruled out after an aldosterone suppression test.Ultimately, Sjögren's syndrome with renal tubular acidosis was diagnosed based on specific autoantibody positivity and symptom correlation. The patient was subsequently referred to the rheumatology department for targeted management. This case underscores the complexities involved in diagnosing multifactorial fatigue and recurrent hypokalemia, and it emphasizes the critical importance of thorough clinical evaluation and interdisciplinary collaboration in identifying underlying autoimmune disorders. Sjögren's Syndrome Hypokalemia Fatigue Renal Tubular Acidosis Autoimmune Disorder Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-7886127\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":531986264,\"identity\":\"f1cab272-2b3e-4d31-b155-7c1dd88cf241\",\"order_by\":0,\"name\":\"Zhi 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