肾小管酸中毒发病隐匿，临床表现复杂，常易误诊，以致晚期合并严重骨病甚至低血钾导致死亡。今列举２例长期误诊病例并对其提出鉴别要点。１　误诊为类风湿性关节炎患者，女，３２岁。１９８９年起无明显诱因的出现多饮、多尿、四肢关节疼痛，以膝、髋及腰部疼痛明显，双手指 Tubular acidosis occult pathogenesis, complex clinical manifestations, often misdiagnosed, resulting in severe combined with advanced bone disease even hypokalemia leading to death. Today cited two cases of long-term misdiagnosis and identification of the main points. 1 misdiagnosed as rheumatoid arthritis patients, female, 32 years old. No apparent incentive since 1989, polydipsia, polyuria, joint pain, knees, hips and waist pain was obvious, both fingers