Khanal, PitambarPaudel, SandipChapagain, SubodhThapa, SauravGyawali, Madan2025-08-272025-08-272023https://hdl.handle.net/20.500.14572/2102Pitambar Khanal Maharajgunj Medical Campus, Maharajgunj, Kathmandu, Nepal Sandip Paudel Maharajgunj Medical Campus, Maharajgunj, Kathmandu, Nepal Subodh Chapagain Manosamajik Apanga Bandi Hospital, Nakkhu, Lalitpur, Nepal Saurav Thapa National Academy of Health Sciences, Mahaboudha, Kathmandu, Nepal Madan Gyawali Department of Internal Medicine, Bakulahar Ratnanagar Hospital, Tandi, Chitwan, NepalAbstract Sjogren's syndrome is a rare chronic autoimmune disease characterised by dry eyes and dry mouth due to autoimmune destruction of the lacrimal and salivary glands, which can occur concurrently with other autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, or thyroiditis. It can lead to renal complications such as interstitial nephritis and glomerulonephritis, with distal/ type 1 renal tubular acidosis which may result in life-threatening electrolyte imbalance. We present a case of a 35-year-old female who presented with complaints of multiple episodes of muscle weakness. Type 1 renal tubular acidosis was discovered to be the cause of her symptoms which lead to the subsequent diagnosis of Sjogren’s syndrome. This is rare presentation of Sjogren’s syndrome, and it poses a challenge to diagnosis. Early detection and diagnosis of Sjogren's syndrome might be difficult due to existing diagnostic criteria, which contributes to a higher likelihood of missed diagnosis.en-USOther