Main Article Content
Abstract
This case study presents a 2-year-old female patient admitted to the paediatric High Dependency Unit (HDU) with symptoms including fever, cough, breathing difficulty, and recent loose stool. Clinical examination revealed severe dehydration and signs of metabolic acidosis characterized by hyperglycaemia and acidotic breathing. Initial management involved fluid resuscitation, mechanical ventilation in Synchronized intermittent mandatory ventilation (SIMV) mode, and insulin therapy. Arterial blood gas analysis indicated hyperchloremic normal anion gap metabolic acidosis, while urine ketone testing was negative. Laboratory investigations revealed severe hypokalaemia, alkaline urine pH, and hypercalciuria. Imaging studies, including X-ray and ultrasonography (USG KUB), showed bilateral nephrocalcinosis and features suggestive of rickets in the long bones. Treatment included conservative measures such as oral potassium chloride syrup, oral sodium bicarbonate, and intravenous amikacin. Continuous monitoring of renal function tests, electrolytes, and arterial blood gases was conducted, leading to clinical improvement and eventual discharge.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
- Singhania P, Neogi S, Bhattacharjee R, et al. Rickets due to renal tubular acidosis: A case report and our perspective. Ann Med Sci Res 2022;1(1):34-7.
- Wrong OM, Davies HEF. The excretion of acid in renal disease. In: van der Meulen JCM, van Acker FGA, Hörl WH, eds. Clinical aspects of acid-base disorders. Springer Berlin Heidelberg 2009:259-77.
- Batlle D, Haque SK. Distal renal tubular acidosis. In: Brophy PD, Strife JM, eds. Pediatric clinical advisor. 2nd edn. Mosby 2012:390-1.
- Liamis G, Elisaf MS. Type IV (Hyperkalemic) renal tubular acidosis. In S. C. Basow, ed. UpToDate 2016.
- Jaramillo D, Collier DS. Renal tubular acidosis. In StatPearls [Internet]. StatPearls Publishing 2020.
References
Singhania P, Neogi S, Bhattacharjee R, et al. Rickets due to renal tubular acidosis: A case report and our perspective. Ann Med Sci Res 2022;1(1):34-7.
Wrong OM, Davies HEF. The excretion of acid in renal disease. In: van der Meulen JCM, van Acker FGA, Hörl WH, eds. Clinical aspects of acid-base disorders. Springer Berlin Heidelberg 2009:259-77.
Batlle D, Haque SK. Distal renal tubular acidosis. In: Brophy PD, Strife JM, eds. Pediatric clinical advisor. 2nd edn. Mosby 2012:390-1.
Liamis G, Elisaf MS. Type IV (Hyperkalemic) renal tubular acidosis. In S. C. Basow, ed. UpToDate 2016.
Jaramillo D, Collier DS. Renal tubular acidosis. In StatPearls [Internet]. StatPearls Publishing 2020.