Once it has been established that GFR is reduced, the physician must decide if this represents acute or chronic renal injury. The one of the various causes of renal diseases is autoimmune disease such as Sjögren syndrome (SS), rheumatoid arthritis, systemic lupus erythematosus (SLE), systemic myopathic diseases and autoimmune thyroid disease. A 44 year-old woman visited this hospital for evaluation of asymptomatic azotemia found by routine medical examination. Urinalysis didn’t showed any proteinuria and hematuria though she said to us the history of asymptomatic proteinuria on the medical examination before 8 years ago. She had diagnosed to hypothyroidism at 10 years ago but didn’t receive any treatment because she didn’t have any symptom. She had waxed and waned purpuric lesions at shin area over 10 years though she didn’t have any purpura when she visited the outpatient clinic. Her laboratory findings were as follow: serum albumin, 4.1 g/dL; serum creatinine 1.48 mg/dL; serum immunoglobulin(Ig) G 2,389.7mg/dL; anti-nuclear Ab, more than 1:2,560; anti ds-DNA Ab IgG/IgM 1/66.5 IU/mL; TSH more than 100.0 mIU/L, free T4 0.41, thyroglobulin Ab 663.50, anti-TPO Ab 74.42 IU/mL. We diagnosed her with SLE and autoimmune thyroid disease. Kidney biopsy revealed chronic interstitial nephritis (CIN) without immune deposit. After then, she complained a little dry mouth and we checked other autoimmumne antibodies and salivary scan. Anti-Ro/La Ab were 3.69/4.79 and salivary scan finding was no uptake on both salivary glands. We diagnosed her with SS, SLE, autoimmune thyroid diseases and CIN secondary to SS. Even though asymptomatic mild azotemia was the only clinical manifestation, we should take the carefully medical history and try to diagnose the disease. We report a 44 year-old woman who diagnosed multiple autoimmune syndrome with CIN revealed by mild azotemia.