{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:54:32Z","timestamp":1781844872086,"version":"3.54.5"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sj\u00f6gren\u2019s disease (an autoimmune exocrinopathy) and Gitelman syndrome (an autosomal recessive renal tubulopathy caused by SLC12A3 mutations) both manifest with hypokalemia. Their coexistence can significantly complicate differential diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 62-years-old female presented with fatigue, dry mouth, and refractory hypokalemia. Immunological testing (positive antinuclear and anti-centromere protein B antibodies) and a labial gland biopsy confirmed Sj\u00f6gren\u2019s disease. However, her severe hypokalemia was disproportionate to Sj\u00f6gren\u2019s-induced renal tubular acidosis alone. Genetic analysis revealed compound heterozygous pathogenic mutations in SLC12A3: c.1196G &amp;gt; A (p.Arg399His) and c.1732G &amp;gt; A (p.Val578Met), confirming concurrent Gitelman syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Combined therapy with potassium supplementation and hydroxychloroquine successfully resolved symptoms and stabilized serum potassium levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In Sj\u00f6gren\u2019s disease patients with refractory hypokalemia, underlying hereditary renal tubular disorders should be suspected. Combining immunological evaluation with genetic testing is crucial to ensure accurate diagnosis and optimize management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1842176","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:30:13Z","timestamp":1781843413000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A case analysis of Gitelman syndrome1 complicated with Sj\u00f6gren\u2019s disease"],"prefix":"10.3389","volume":"13","author":[{"given":"Yuqi","family":"Tang","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sen","family":"Tian","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhejiang Chinese Medical University","place":["Hangzhou, 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