title: Hashimoto Thyroiditis and Nephrocalcinosis in a Child with Down Syndrome.
abstract: BACKGROUND
  Hypothyroidism has been reported to affect renal function and structure. However, the association of hypothyroidism with distal renal tubular acidosis (dRTA) is rarely reported in children.
  
  
  METHODS
  We present a 6-year-boy with Down syndrome admitted in our department due to vomiting, weakness, polyuria, polydipsia, irritability and weight loss in the last few weeks. Investigations revealed features of hypokalemia, metabolic acidosis and alkaline urine consistent with dTRA. Abdominal ultrasound found nephrocalcinosis. In addition, Antithyroid peroxidase antibodies were positive, suggesting an autoimmune background for the pathogenesis of the tubular dysfunction. Treatment for dRTA and hypothyroidism was started and symptomatic improve was noticed.
  
  
  CONCLUSIONS
  dRTA should be excluded in children with autoimmune disorders who develop weakness, polyuria, polydipsia or growth failure. Early diagnosis would reduce long-term complications.
authors.affiliation: Pediatric Clinic, University Clinical Center of Kosovo, Pristina, Republic of Kosovo.
authors.forename: Lidvana
authors.initials: L
authors.lastname: Spahiu
authors.affiliation: Pediatric Clinic, University Clinical Center of Kosovo, Pristina, Republic of Kosovo; Department of Public Health and Clinical Medicine, Umeå University, Sweden.
authors.forename: Haki
authors.initials: H
authors.lastname: Jashari
authors.affiliation: Pediatric Clinic, University Clinical Center of Kosovo, Pristina, Republic of Kosovo.
authors.forename: Vjosa
authors.initials: V
authors.lastname: Mulliqi-Kotori
authors.affiliation: Pediatric Clinic, University Clinical Center of Kosovo, Pristina, Republic of Kosovo.
authors.forename: Blerta
authors.initials: B
authors.lastname: Elezi-Rugova
authors.affiliation: Pediatric Clinic, University Clinical Center of Kosovo, Pristina, Republic of Kosovo.
authors.forename: Besart
authors.initials: B
authors.lastname: Merovci
keywords: Down syndrome; Hashimoto thyroiditis; distal renal tubular acidosis; nephrocalcinosis