All issues > Volume 19(11); 1976

Case Report

J Korean Pediatr Soc. 1976;19(11):878-885. Published online November 30, 1976.

A Case of Distal Type of Renal Tubular Acidosis with Nephrocalcinosis

Tai Hyuk Yim¹, Ho Woong Doh¹, Don Hee Ahn¹, Keun Chan Sohn¹

¹Department of Pediatrics, National Medical Center, Seoul, Korea

Abstract

A 7 year-old boy was admitted to Ped. dept, of N.M.C. due to waddling gait and knock knee. He was diagnosed as rickets at 5 years of his age and irregular vitamin D treatment was given without improvement at local clinics. Physical examination on admission showed a picture of full blown rickets such as poor development, waddling gait, double malleoli, knock knee, widening of both wrists, rachitic rosary and compatible x-ray pictures. I.V.P. showed bilateral nephrocalcinosis with normal excretory function. Laboratory data showed low serum calcium, normal serum phosphorus and high alkaline phosphatase levels. Blood gas analysis (Astrup) showed compensated metabolic acidosis. In spite of these data, urine pH was above 6. 0. Under the impression of renal tubular acidosis of distal type, high dose of vitamin D was given, accompanied by alkali therapy with Shohl’s solution. After 5 weeks of treatment, marked improvement was noted both in clinical symptoms and laboratory results. With the review of literatures, the case was presented.

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