title: Distal renal tubular acidosis and hypokalemic paralysis in a patient with hypothyroidism.
abstract: A 43- year- old woman on treatment for primary hypothyroidism presented with 1- day progressive weakness of all her limbs and history of similar episodes in the past. Clinical examination revealed grade 2 hyporeflexive weakness. Investigations revealed features of hypokalemia, metabolic acidosis, alkaline urine, and a fractional bicarbonate excretion of 3.5%, consistent with distal renal tubular acidosis. Antithyroid peroxidase and antithroglobulin antibodies were positive, suggesting an autoimmune basis for the pathogenesis of the functional tubular defect. Bicarbonate therapy resulted in a sustained clinical recovery.
authors.affiliation: Department of Internal and Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, India. parvaizk@rediffmail.com
authors.forename: Parvaiz Ahmad
authors.initials: PA
authors.lastname: Koul
authors.forename: A
authors.initials: A
authors.lastname: Wahid
mesh_terms: D000141:Acidosis, Renal Tubular / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D000328:Adult; D005260:Female; D006801:Humans; D020514:Hypokalemic Periodic Paralysis / Q000209:etiology* / Q000276:immunology; D007037:Hypothyroidism / Q000150:complications* / Q000276:immunology; D007668:Kidney / Q000276:immunology; D017693:Sodium Bicarbonate / Q000627:therapeutic use; D027981:Symporters / Q000502:physiology
chemical_list: D027981:Symporters; D017693:Sodium Bicarbonate