The 475th case: renal tubular acidosis, renal failure, anemia, and lactic acidosis
10.3760/cma.j.issn.0578-1426.2020.02.015
- VernacularTitle: 第475例——肾小管酸中毒，肾衰竭，贫血，乳酸酸中毒
- Author:
Gang CHEN
1
;
Dong WU
2
;
Mingxi LI
1
Author Information
1. Department of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
2. Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
- Publication Type:Journal Article
- Keywords:
Acidosis, renal tubular;
Kidney failure;
Fanconi syndrome;
Acidosis, Lactic;
Lymphoma
- From:
Chinese Journal of Internal Medicine
2020;59(2):165-168
- CountryChina
- Language:Chinese
-
Abstract:
A 47-year-old female patient presented nausea and vomiting for half a year and elevated serum creatinine for 3 days. Proximal renal tubular acidosis (RTA) complicated with anemiawas confirmed after admission. Secondary factors, such as autoimmune disease, drugs, poison, monoclonal gammopathy, were excluded. Renal biopsy revealed acute interstitial nephritis. The patient was administrated with daily prednisone 50 mg, sodium bicarbonate 4 g, 3 times per day, erythropoietin 3 000 U, 2 times per week, combined with potassium, calcium, and calcitriol tablets. Serum creatinine reduced to 90 μmol/L. However nausea and vomiting deteriorated with lactic acidosis. Bone marrow biopsy indicated the diagnosis of non-Hodgkin lymphoma, therefore the patient was treated with chemotherapy. Although metabolic acidosis improved gradually after chemotherapy, severe pneumocystis carinii pneumonia developed two weeks later. The patient refused further treatment and was discharged.
