This is a case summary of renal rickets with renal tubular acidosis most probably distal RTA.
Shehrin, 6 years old female child, immunized as per EPI schedule, 1st issue of her non consanguineous parents of low socioeconomic condition, hailing from Demra, Dhaka with the complaints of not growing well according to her age since 2 years of her age, Frequent micturation and excessive water intake for 2 and half years, bowing of leg and history of frequent fall during walking for last 5 months. She had no history of increased appetite for food, hearing or visual problems, fever, vomiting, constipation, pneumonia or diarrhea.
On examination she is well alert, not anemic, edema and dehydration was absent, her height is 93 cm, BMI 17.1. On locomotor system examination, bowing of leg was present, muscle, bulk, power tone was normal. Alimentary system examination reveals no organomegaly, other system examination reveals no abnormality.
Height: 93 cm
Weight: 15 Kg
No Rachitic rosary or Harrison’s sulcus.\
Complete Blood Count:
- Hb: 13.5 gm/dl\
- ESR: 18 mm Hg in 1st
- Platelets: 360 000/cmm
- WBC: 12000/cmm
PBF: Non specific findings.
Urine Bence Jones Protein: Absent
- Reaction PH: 8.0?
- Protein: Trace
- Ex Phosphate: Nil
- Casts: absent
- Epithelial cells: Nil
- Na= 138 mmol/l
- K= 3.2 mmol/l
- Chloride=114 mmol/l
Serum inorganic Phosphate: 2.3 mg/dl (N=2.3-4.7)
Serum Calcium: 8.7 mg/dl
Alkaline Phosphatase: 578 U/L (N= 30-120 U/L)
Urine culture: No growth
Urinary Potassium: 9.5 mmol/day (N= 25-125)
Urinary Sodium: 66 mmol/day (N= 40-220)
Serum Urea: 25 mg/dl
Serum Creatinine: 0.46 mg/dl
This patient was discharged with advice for follow up after 1 week.
Renal Tubular Acidosis Syndromes Medscape
Renal Rickets [Must to Download]
This patient was previously diagnosed with Renal Rickets and came to us for Follow up. As it is a good academic case, i have just made a record. I really dont know much about it. Thanks. Hope you have enjoyed it.