{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T05:23:37Z","timestamp":1787635417777,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Sjogren's syndrome may rarely present with distal renal tubular acidosis (dRTA), causing severe hypokalemia and myopathy. A 27\u2010year\u2010old primigravida at 15\u2009weeks gestation presented with progressive proximal weakness and myalgia. Labs showed hypokalemia (1.76\u2009mmol\/L), hyperchloremic metabolic acidosis, and elevated creatine phosphokinase; urinary pH was 7.0. Anti\u2010SSA\/Ro and anti\u2010SSB\/La antibodies and a positive Schirmer's test confirmed primary Sjogren's syndrome. Although 16%\u201367% of Sjogren's syndrome patients present with renal involvement, hypokalemic myopathy due to dRTA in association with Sjogren's syndrome in pregnancy is a very rare presentation. Electromyography showed myopathic changes. Pregnancy likely worsened the electrolyte imbalance. This case highlights the need to consider autoimmune causes in pregnant patients with unexplained hypokalemia and weakness for timely diagnosis and management.<\/jats:p>","DOI":"10.1002\/ccr3.71488","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T03:50:21Z","timestamp":1763524221000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Sj\u00f6gren's Syndrome With Distal Renal Tubular Acidosis and Hypokalemic Myopathy in Pregnancy: A Rare Case"],"prefix":"10.1002","volume":"13","author":[{"given":"Nabiha","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Medicine Punjab Medical College  Faisalabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aasim","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Neurology Allied Hospital  Faisalabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8276-2059","authenticated-orcid":false,"given":"Sadia","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Medicine Nishtar Medical University  Multan Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uzka","family":"Ghayour","sequence":"additional","affiliation":[{"name":"Department of Medicine Nishtar Medical College and Hospital  Multan Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3120-2542","authenticated-orcid":false,"given":"Dipesh Kumar","family":"Yadav","sequence":"additional","affiliation":[{"name":"Bardibas Hospital  Mahottari Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armaghana","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Allied Hospital  Faisalabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3238\/arztebl.2017.0354"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.6.554"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2009.11.004"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0300060519880765"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13256\u2010024\u201004563\u20107"},{"issue":"6","key":"e_1_2_13_7_1","first-page":"91","article-title":"Kanal'tsevy\u012d ATSIDOZ i Gipokaliemicheski\u012d Periodicheski\u012d Paralich Pri Bolezni Shegrena [Tubular Acidosis and Hypokalemic Periodic Paralysis in Sj\u00f6gren's Syndrome]","volume":"60","author":"Ivanova A. V.","year":"1988","journal-title":"Terapevticheski\u012d Arkhiv"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.3238\/arztebl.m2021.0353"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/jclinepi.2017.04.026"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10238\u2010021\u201000728\u20106"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kev223"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.7555"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.933957"},{"issue":"3","key":"e_1_2_13_14_1","first-page":"324","article-title":"Hypokalemisk Induserte Pareser Sekundaert Til Renal Tubulaer Acidose [Hypokalemic Pareses Secondary to Renal Tubular Acidosis]","volume":"120","author":"G\u00f8ransson L. G.","year":"2000","journal-title":"Tidsskrift for Den Norske Laegeforening: Tidsskrift for Praktisk Medicin, Ny Raekke"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/16\u2010047"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.5114\/reum.2019.89520"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.4038\/ajim.v3i1.121"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.940268"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.7860\/JCDR\/2014\/8793.4433"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/ddg.14823"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005512"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.71488","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T05:52:28Z","timestamp":1765259548000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.71488"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":20,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/ccr3.71488"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.71488","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"2025-08-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71488"}}