Abstract
A 5-year-old girl with distal renal tubular acidosis (RTA) and hypokalemic muscle paralysis is reported. RTA is a known cause of hypokalemia, but in spite of the presence of persistent hypokalemia muscular paralysis is uncommon, rarely described in children, and the onset of paralysis may initially be misinterpreted particularly if the patient is attended by a physician who is not a pediatric nephrologist. Therefore parents must be informed about this possibility. Still, as the clinical appearance of hypokalemic paralysis is quite similar to familial hypokalemic periodic paralysis, and because the emergent and prophylactic treatment of the two disorders are quite different, we discuss the diagnostic evaluation and the treatment for both of them.
This is a preview of subscription content, log in via an institution to check access.
References
Chang Y-C, Huang C-C, Chiou Y-Y, Yu C-Y (1995) Renal tubular acidosis complicated with hypokalemic periodic paralysis. Pediatr Neurol 13:52–54
Christensen KS (1985) Hypokalemic periodic paralysis secondary to renal tubular acidosis. Eur Neurol 24:303–305
Ruf R, Rensing C, Topaloglu R, Guay-Woodford L, Klein C, Vollmer M, Otto E, Beekmann F, Haller M, Wiedensohler A, Leumann E, Antignac C, Rizzoni G, Filler G, Brandis M, Weber JL, Hildebrandt (2003) Confirmation of the ATP6B1 gene as responsible for distal renal tubular acidosis. Pediatr Nephrol 18:105–109
Kurtzman NA (1990) Disorders of distal acidification. Kidney Int 38:720–727
Owen EE, Verner JV (1960) Renal tubular disease with muscle paralysis and hypokalemia. Am J Med 28:8–21
Rowbottom SJ, Ray DC, Brown DT (1987) Hypokalemic paralysis associated with renal tubular acidosis. Crit Care Med 15:1067–1068
Koul PA, Saleem SM (1992) Chronic active hepatitis with renal tubular acidosis presenting as hypokalemic periodic paralysis with respiratory failure. Acta Paediatr 81:568–569
Nardone DA, Mcdonald WJ, Girard DE (1978) Mechanisms in hypokalemia: clinical correlation. Medicine (Baltimore) 57:435–446
Narins RG, Goldberg M (1977) Renal tubular acidosis: pathophysiology, diagnosis and treatment. Dis Mon 23:1–66
Quintanilla AP (1980) Renal tubular acidosis: mechanisms and management. Postgrad Med 67:60–73
Raskin RJ, Tesar JT, Lawless OJ (1981) Hypokalemic periodic paralysis in Sjögren’s syndrome. Arch Intern Med 141:1671–1673
Biemond A, Polak DA (1934) Familial periodic paralysis and its transition into spinal muscular atrophy. Brain 57:91
Burume OJS, BotsGth AM, Lodewyk NW (1985) Familial hypokalemia period paralysis: 50-year follow-up of a large family. Arch Neurol 42:28
De Vivo DC, DiMauro S (1999) Hereditary and acquired types of myopathy. In: DeAngelis CD, Feigin RD, Warshaw JB (eds) Oski’s pediatrics principles and practice, 3rd edn. Lippincott Williams & Wilkins, Philadelphia, 1971–1987
Stemberg D, Maisonobe T, Jurkat-Rott K, Nicole S, Launay E, Chauveau D, Tabti N, Lehmann-Horn F, Hainque B, Fontaine B (2001) Hypokalaemic periodic paralysis type 2 caused by mutations at codon 672 in the muscle sodium channel gene SCN4A. Brain 124: 1091–1099
Steen B (1981) Hypokalemia-Clinical spectrum and etiology. Acta Med Scand Suppl 647:61–66
Koul PA, Saleem SM, Bhat D (1993) Sporadic distal renal tubular acidosis and periodic hypokalaemic paralysis in Kashmir. J Intern Med 233:463–466
Stephens FI (1949) Paralysis due to reduced serum potassium during treatment of diabetic acidosis. Am Intern Med 30:1272
Frenkel M, Groen J, Willebrands AF (1947) Low serum potassium during recovery from diabetic coma. Arch Intern Med 80:728
Acknowledgements
This contribution was revised by Fernando S. Vugman, Ph.D.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bresolin, N.L., Grillo, E., Fernandes, V.R. et al. A case report and review of hypokalemic paralysis secondary to renal tubular acidosis. Pediatr Nephrol 20, 818–820 (2005). https://doi.org/10.1007/s00467-005-1833-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00467-005-1833-9