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Complicated Pregnancy in a Patient with Distal Renal Tubular Acidosis, Systemic Lupus Erythematosus, and Antiphospholipid Syndrome: A Rare Case and Management Strategies

ACTA MEDICA INDONESIANA · Vol. 57 No. 4 (2025)

ISSN
2338-2732, 0125-9326
Published
2025-12-23
Publisher
The Indonesian Society of Internal Medicine
Language
eng
License
creativecommons.org/licenses/by/4.0

Abstract

Distal renal tubular acidosis (dRTA) is a rare disorder characterized by impaired acid excretion leading to metabolic acidosis and hypokalemia. Its occurrence during pregnancy, particularly alongside systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS), poses significant challenges for both maternal and fetal outcomes. This case report describes the successful management of a 23-year-old woman with secondary dRTA, SLE, and APS during pregnancy. The patient, with a history of recurrent hypokalemia and previous preterm deliveries, was closely monitored by a multidisciplinary team. Throughout her pregnancy, she required significant potassium and bicarbonate supplementation to maintain electrolyte and acid-base balance. Additionally, hydroxychloroquine, methylprednisolone, aspirin, and unfractionated heparin were continued to manage SLE and APS. Despite the complexity of her condition, she delivered a healthy baby girl at 37 weeks via cesarean section. This case provides valuable insights into managing dRTA during pregnancy, highlighting the importance of customized approaches to the management of electrolyte and acid-base abnormalities, as well as that of autoimmune disease.

Keywords

Collaboration network of the authors

40 authors · 237 co-authorship links · showing the 40 most connected

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Co-authorOrganisationJoint articles
Anshari Saifuddin HasibuanAffiliation unknown7
Sukamto KoesnoeAffiliation unknown7
Suzy MariaAffiliation unknown6
Evy YunihastutiAffiliation unknown6
Hamzah ShatriAffiliation unknown6
Ikhwan RinaldiAffiliation unknown6
Pringgodigdo NugrohoAffiliation unknown6
Iris RengganisAffiliation unknown4
Rudi PutrantoAffiliation unknown4
Sally Aman NasutionAffiliation unknown4
Lili LegiawatiAffiliation unknown4
Andhika RachmanAffiliation unknown3
Teguh Harjono KarjadiAffiliation unknown3
Samsuridjal DjauziAffiliation unknown3
Chyntia Olivia Maurine JasirwanAffiliation unknown3
Eka GinanjarAffiliation unknown3
Karmel L TambunanAffiliation unknown2
Ina S TimanAffiliation unknown2
Teguh H KarjadiAffiliation unknown2
Dyah PurnamasariAffiliation unknown2
Simon SalimAffiliation unknown2
Nurul Inayah RahmaniAffiliation unknown2
Bramantya WicaksanaAffiliation unknown2
Rudy HidayatAffiliation unknown2
Dina ElitaAffiliation unknown2
Andi Makbul AmanAffiliation unknown2
Erwanto Budi WinulyoAffiliation unknown2
Andri Maruli T LubisAffiliation unknown1
Kurniadi HusodoAffiliation unknown1
Djajadiman GatotAffiliation unknown1
Arini SetiawatiAffiliation unknown1
T. Djumhana AtmakusumaAffiliation unknown1
Shufrie EffendiAffiliation unknown1
Al RasyidAffiliation unknown1
Jusuf MisbachAffiliation unknown1
Jan S PurbaAffiliation unknown1

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">Complicated Pregnancy in a Patient with Distal Renal Tubular Acidosis, Systemic Lupus Erythematosus, and Antiphospholipid Syndrome: A Rare Case and Management Strategies</dc:title>
	<dc:creator>Asmara, I Gede Yasa</dc:creator>
	<dc:creator>Widhani, Alvina</dc:creator>
	<dc:creator>Sukrisman, Lugyanti</dc:creator>
	<dc:creator>Marbun, Maruhum Bonar Hasiholan</dc:creator>
	<dc:subject xml:lang="en-US">Hypokalemia</dc:subject>
	<dc:subject xml:lang="en-US">Pregnancy</dc:subject>
	<dc:subject xml:lang="en-US">SLE</dc:subject>
	<dc:subject xml:lang="en-US">Antiphospholipid Syndrome</dc:subject>
	<dc:subject xml:lang="en-US">acidosis</dc:subject>
	<dc:subject xml:lang="en-US">renal tubular</dc:subject>
	<dc:subject xml:lang="en-US">Distal Renal Tubular Acidosis</dc:subject>
	<dc:description xml:lang="en-US">Distal renal tubular acidosis (dRTA) is a rare disorder characterized by impaired acid excretion leading to metabolic acidosis and hypokalemia. Its occurrence during pregnancy, particularly alongside systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS), poses significant challenges for both maternal and fetal outcomes. This case report describes the successful management of a 23-year-old woman with secondary dRTA, SLE, and APS during pregnancy. The patient, with a history of recurrent hypokalemia and previous preterm deliveries, was closely monitored by a multidisciplinary team. Throughout her pregnancy, she required significant potassium and bicarbonate supplementation to maintain electrolyte and acid-base balance. Additionally, hydroxychloroquine, methylprednisolone, aspirin, and unfractionated heparin were continued to manage SLE and APS. Despite the complexity of her condition, she delivered a healthy baby girl at 37 weeks via cesarean section. This case provides valuable insights into managing dRTA during pregnancy, highlighting the importance of customized approaches to the management of electrolyte and acid-base abnormalities, as well as that of autoimmune disease.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2025-12-23</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2944</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 57 No. 4 (2025): Acta Medica Indonesiana; 508</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2944/834</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2025 I Gede Yasa Asmara, Alvina Widhani, Lugyanti Sukrisman, Maruhum Bonar Hasiholan Marbun</dc:rights>
	<dc:rights xml:lang="en-US">https://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>