{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T03:50:23Z","timestamp":1780372223723,"version":"3.54.1"},"reference-count":16,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,7,24]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>We present a 44-year-old female with an initial presentation with distal renal tubular acidosis (RTA) after she presented with hypokalaemia and normal anion gap acidosis. Three years following the diagnosis, she presented with progressive renal impairment. In the absence of any clinical, biochemical and radiological clues, she underwent a renal biopsy which showed severe tubulitis secondary to lymphocytic infiltration. Serological investigations subsequently revealed positive anti-nuclear, anti-Sj\u00f6gren\u2019s syndrome related antigen A (SS-A), and anti-Sj\u00f6gren\u2019s syndrome related antigen B (SS-B) antibodies, supporting the diagnosis of Sj\u00f6gren\u2019s syndrome. This case is unique in that distal RTA was the presenting clinical manifestation of Sj\u00f6gren\u2019s syndrome. We hope that a consideration for Sj\u00f6gren\u2019s syndrome is made in patients with seemingly idiopathic RTA.<\/jats:p>","DOI":"10.1136\/bcr-2019-230402","type":"journal-article","created":{"date-parts":[[2019,8,14]],"date-time":"2019-08-14T07:18:25Z","timestamp":1565767105000},"page":"e230402","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Renal tubular acidosis as the initial presentation of Sj\u00f6gren\u2019s syndrome"],"prefix":"10.1136","volume":"12","author":[{"given":"Karen","family":"Ho","sequence":"first","affiliation":[{"name":"University of Saskatchewan College of Medicine, Saskatoon, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pouneh","family":"Dokouhaki","sequence":"additional","affiliation":[{"name":"University of Saskatchewan College of Medicine, Saskatoon, 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