Seong EY, Kim DW, Kim HJ, Rhee H, Song SH. Incomplete distal renal tubular acidosis uncovered during pregnancy: A case report. World J Clin Cases 2023; 11(25): 5988-5993 [PMID: 37727491 DOI: 10.12998/wjcc.v11.i25.5988]
Corresponding Author of This Article
Eun Young Seong, MD, PhD, Professor, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, South Korea. sey-0220@hanmail.net
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2023; 11(25): 5988-5993 Published online Sep 6, 2023. doi: 10.12998/wjcc.v11.i25.5988
Incomplete distal renal tubular acidosis uncovered during pregnancy: A case report
Eun Young Seong, Da Woon Kim, Hyo Jin Kim, Harin Rhee, Sang Heon Song
Eun Young Seong, Hyo Jin Kim, Harin Rhee, Sang Heon Song, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Eun Young Seong, Hyo Jin Kim, Harin Rhee, Sang Heon Song, Department of Internal Medicine, School of Medicine, Pusan National University, Yangsan-si 50612, Gyeongsangnam-do, South Korea
Da Woon Kim, Department of Internal Medicine, Pusan National University School of Medicine, Busan 49241, South Korea
Author contributions: Kim DW collected clinical data and drafted the manuscript; Kim HJ and Rhee H reviewed the manuscript and provided intellectual input; Song SH and Seong EY reviewed the literature and revised the manuscript; all the authors have read and approved the final version of the manuscript.
Supported byClinical Research Grant from Pusan National University Hospital in 2022.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eun Young Seong, MD, PhD, Professor, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, South Korea. sey-0220@hanmail.net
Received: May 24, 2023 Peer-review started: May 24, 2023 First decision: June 15, 2023 Revised: July 12, 2023 Accepted: August 8, 2023 Article in press: August 8, 2023 Published online: September 6, 2023 Processing time: 100 Days and 2.1 Hours
Abstract
BACKGROUND
Renal tubular acidosis (RTA) is a renal cause of non-anion-gap metabolic acidosis characterized by low urinary ammonia excretion. This condition has a low prevalence, and various congenital and acquired etiologies. To date, only a few cases of idiopathic RTA uncovered during pregnancy have been reported.
CASE SUMMARY
A previously healthy 32-year-old Korean woman at 30 wk of gestation was admitted to Pusan National University Hospital with preterm labor. At admission, the patient presented with hypokalemia, non-anion-gap metabolic acidosis, and nephrocalcinosis. Distal RTA was diagnosed based on laboratory blood and urine findings and imaging examinations. Various tests, including next-generation gene sequencing panels for nephropathy, were performed to determine the etiology of the disease, which indicated that it was idiopathic. The patient received sodium bicarbonate and potassium chloride supplementation. After 3 wk, she delivered a baby who was subsequently diagnosed with corpus callosum agenesis and colpocephaly. During regular follow-ups for 6 mo postpartum, her hypokalemia and metabolic acidosis were gradually resolved, and medications eventually discontinued.
CONCLUSION
Herein we describe a case of idiopathic distal RTA discovered during pregnancy. Hypokalemia and metabolic acidosis resolved spontaneously after delivery.
Core Tip: Renal tubular acidosis is a rare disease that presents as non-anion-gap metabolic acidosis. To the best of our knowledge, only a few cases of idiopathic distal renal tubular acidosis uncovered during pregnancy have been reported. To date, the exact pathophysiology by which pregnancy activates this condition has not been established.
