Background Sjögren’s 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. Methods 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 Sjögren’s disease. However, he