title: Systemic lupus erythematosus associated with type 4 renal tubular acidosis: a case report and review of the literature.
abstract: BACKGROUND
  Type 4 renal tubular acidosis is an uncommon clinical manifestation of systemic lupus erythematosus and has been reported to portend a poor prognosis. To the best of our knowledge, this is the first case report which highlights the successful management of a patient with systemic lupus erythematosus complicated by type 4 renal tubular acidosis who did not do poorly.
  
  
  METHODS
  A 44-year-old Hispanic woman developed a non-anion gap hyperkalemic metabolic acidosis consistent with type 4 renal tubular acidosis while being treated in the hospital for recently diagnosed systemic lupus erythematosus with multi-organ involvement. She responded well to treatment with corticosteroids, hydroxychloroquine and mycophenolate mofetil. Normal renal function was achieved prior to discharge and remained normal at the patient's one-month follow-up examination.
  
  
  CONCLUSIONS
  This case increases awareness of an uncommon association between systemic lupus erythematosus and type 4 renal tubular acidosis and suggests a positive impact of early diagnosis and appropriate immunosuppressive treatment on the patient's outcome.
authors: Department of Internal Medicine, University of Miami/Jackson Memorial Hospital, 1611 NW 12th Avenue, Miami, FL 33136, USA. hporteous@med.miami.edu.
authors: Haldane
authors: H
authors: Porteous
authors: Nadia
authors: N
authors: Morgan
authors: Julio
authors: J
authors: Lanfranco
authors: Monica
authors: M
authors: Garcia-Buitrago
authors: Larry
authors: L
authors: Young
authors: Oliver
authors: O
authors: Lenz