Evidence map›Paper›PMID 41022418›Full record

ArticleBMJ case reports2025

The challenges of managing distal renal tubular acidosis in pregnant patients with primary Sjögren's disease.

Elizabeth K Chu, William L Clapp, Sewar Abuarqob, Omar A Tolaymat

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Distal Renal Tubular Acidosis in Pregnancy: A Case Report and Systematic Literature Review.European journal of case reports in internal medicine · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Elizabeth K ChuRheumatology, University of Florida, Gainesville, Florida, USA e.chu@ufl.edu.ORCID http://orcid.org/0009-0000-6892-1322
William L ClappPathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, Florida, USA.
Sewar AbuarqobRheumatology, University of Florida, Gainesville, Florida, USA.ORCID http://orcid.org/0000-0002-9735-7588
Omar A TolaymatRheumatology, University of Florida, Gainesville, Florida, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We present a case of a pregnant woman in her 40 s diagnosed with primary Sjögren's disease (pSjD) complicated by distal type I renal tubular acidosis. At 12 weeks' gestation, she exhibited dry eyes, dry mouth and renal dysfunction for the first time. Electrolyte studies confirmed hyperchloraemic normal anion gap metabolic acidosis with elevated urine pH. Positive serologies included +ANA, +SSA and +RF. Schirmer's test was positive. Renal biopsy indicated chronic tubulointerstitial nephritis with 40% interstitial fibrosis. Hydroxychloroquine and prednisone (60 mg daily) improved renal function, but rapid tapering led to mild worsening in renal function, sicca symptoms and fetal growth restriction. Steroid dose escalation and azathioprine initiation led to clinical improvements. At 35 weeks' gestation, she delivered preterm due to pre-eclampsia and intrahepatic cholestasis. The neonate had cutaneous neonatal lupus but was otherwise healthy. This case highlights the clinical complexity of managing distal renal tubular acidosis in pregnant patients with pSjD and the need for evidence-based treatment guidelines.

Indexed as

Acidosis, Renal TubularPregnancy ComplicationsSjogren's SyndromeAdultAzathioprineFemaleHumansHydroxychloroquineInfant, NewbornPrednisonePregnancyAzathioprineHydroxychloroquinePrednisoneDrugs: obstetrics and gynaecologyFluid electrolyte and acid-base disturbancesPregnancySjogren's syndrome

Identifiers

PMID41022418
PMCPMC12481184

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.