Electrolyte Imbalances and Nephrocalcinosis in Acute Phosphate Poisoning on Chronic Type 1 Renal Tubular Acidosis due to Sjogren's Syndrome.
10.3346/jkms.2013.28.2.336
- Author:
Sung Gun CHO
1
;
Joo Hark YI
;
Sang Woong HAN
;
Ho Jung KIM
Author Information
1. Renal Division, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea. Joohark@hanyang.ac.kr
- Publication Type:Case Reports
- Keywords:
Hypocalcemia;
Nephrocalcinosis;
Sodium Phosphate;
Distal RTA;
Sjogren's Syndrome
- MeSH:
Acidosis, Renal Tubular/*diagnosis/etiology;
Acute Disease;
Adult;
Antibodies, Antinuclear/blood;
Calcium Gluconate/therapeutic use;
Chronic Disease;
Female;
Humans;
Hydrogen-Ion Concentration;
Hypocalcemia/*chemically induced/complications/drug therapy;
Nephrocalcinosis/complications/*diagnosis/ultrasonography;
Parotid Gland/ultrasonography;
Phosphates/*adverse effects;
Salivary Glands/radionuclide imaging;
Sjogren's Syndrome/complications/*diagnosis/metabolism;
Submandibular Gland/ultrasonography
- From:Journal of Korean Medical Science
2013;28(2):336-339
- CountryRepublic of Korea
- Language:English
-
Abstract:
Although renal calcium crystal deposits (nephrocalcinosis) may occur in acute phosphate poisoning as well as type 1 renal tubular acidosis (RTA), hyperphosphatemic hypocalcemia is common in the former while normocalcemic hypokalemia is typical in the latter. Here, as a unique coexistence of these two seperated clinical entities, we report a 30-yr-old woman presenting with carpal spasm related to hypocalcemia (ionized calcium of 1.90 mM/L) due to acute phosphate poisoning after oral sodium phosphate bowel preparation, which resolved rapidly after calcium gluconate intravenously. Subsequently, type 1 RTA due to Sjogren's syndrome was unveiled by sustained hypokalemia (3.3 to 3.4 mEq/L), persistent alkaline urine pH (> 6.0) despite metabolic acidosis, and medullary nephrocalcinosis. Through this case report, the differential points of nephrocalcinosis and electrolyte imbalances between them are discussed, and focused more on diagnostic tests and managements of type 1 RTA.
