Adult-Onset Distal Renal Tubular Acidosis with Hypokalemic Quadriparesis in a Patient with Autoimmune Hypothyroidism

Naveen, L.; Malkarnekar, Santoshi Balkrishna

doi:10.4103/2225-1243.143392

Cited by 3 publications

(3 citation statements)

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“…HP with hypothyroidism has been reported on 15 occasions previously (16 adults, 2 children). [ 4 5 6 7 8 9 10 11 12 ] Eleven (11/18) patients with HP had hypokalemic periodic paralysis (HPP). One patient had resistance to thyroid hormone and was already on L-thyroxine without improvement in his episodic paralysis.…”

Section: Discussionmentioning

confidence: 99%

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Sporadic hypothyroidism-related hypokalemic paralysis: Diagnosis in a resource-poor setting

Kadeeja

Senthilnathan

Viswanathan

et al. 2017

J Family Med Prim Care

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Hypothyroidism and distal renal tubular acidosis causing hypokalemic paralysis (HP) have been described only in four female patients. HP as the initial manifestation of uncomplicated diabetes has been reported only in three young males. We report two middle-aged patients presenting with gradual-onset areflexic quadriparesis and neck flop, associated with urinary potassium losses, and recovering over 3 days. The male patient with alcohol abuse had urine pH >5.5 and hyperchloremic metabolic acidosis due to renal tubular acidosis and hypothyroidism. The second, a hypertensive female, had metabolic alkalosis, hypomagnesemia, and diabetes mellitus diagnosed at admission. Both these patients improved with intravenous and oral potassium supplementation.

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Section: Discussionmentioning

confidence: 99%

“…Five reports had females with both DRTA and hypothyroidism. [ 5 10 ] Three (3/5) were already hypothyroid and had HPP. The remaining two patients (2/5) with sporadic HP at presentation were female and had both Hashimoto's thyroiditis and Sjogren's; the second patient had systemic lupus erythematosus (SLE), additionally.…”

Section: Discussionmentioning

confidence: 99%

Sporadic hypothyroidism-related hypokalemic paralysis: Diagnosis in a resource-poor setting

Kadeeja

Senthilnathan

Viswanathan

et al. 2017

J Family Med Prim Care

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“…Few case reports have reported on the exclusive association between distal RTA and Hashimoto's thyroiditis (9)(10)(11)(12)(13). Females were mostly affected, and at an average age of 30 years.…”

Section: Discussionmentioning

confidence: 99%

Distal renal tubular acidosis in a patient with Hashimoto’s thyroiditis

Mhlana¹,

Korf²,

Davids³

et al. 2023

Biochem. med. (Online)

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Renal tubular acidosis (RTA) is a rare disorder that can be inherited or acquired, and results in an inability of the kidneys to maintain normal acid-base balance. We present a case of recurrent, severe hypokalaemia and rhabdomyolysis in a young woman who had an associated normal anion gap metabolic acidosis and was subsequently diagnosed with distal RTA associated with Hashimoto’s thyroiditis. Distal RTA associated with Hashimoto’s thyroiditis is rare and probably develops because of autoimmune-mediated mechanisms, causing an inability of the H+-ATPase pump in alpha-intercalated cells of the cortical collecting duct to secrete H+, with subsequent failure of urinary acidification. In this case, this hypothesis was supported by the exclusion of common genetic mutations associated with distal RTA. We illustrate that utilizing a systematic, physiology-based approach for challenging electrolyte and acid-base disorders enables identification of the root cause and underlying disease mechanisms.

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