Key result
Sodium bicarbonate and potassium supplementation successfully treated severe bulbar, respiratory, and limb paralysis in a 22-year-old woman with distal renal tubular acidosis.
Case Report (n=1)
Highlights the importance of differentiating renal tubular acidosis from familial periodic paralysis in patients presenting with respiratory paralysis and hypokalemia, as treatments differ and can aggravate the alternative condition.
Successful bicarbonate-potassium therapy in distal RTA paralysis supports differentiation from periodic paralysis; leaves open prospective validation.
Respiratory paralysis due to renal tubular acidosis (RTA) is rare. We report a 22-year-old lady who developed severe bulbar, respiratory and limb paralysis following respiratory infection. She had hypokalemia (1.6 meq/L) and hyperchloremic (110 meq/l) acidosis (pH 7.1). She was diagnosed as distal RTA by ammonium chloride test. She improved following sodium bicarbonate and potassium supplementation. RTA should be differentiated from familial periodic paralysis (FPP) because acetazolamide used in FPP aggravates RTA and sodium bicarbonate used in RTA aggravates hypokalemic periodic paralysis.
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Kalita et al. (2010) conducted a case report in Renal tubular acidosis with respiratory paralysis (n=1). Sodium bicarbonate and potassium supplementation was evaluated on Clinical improvement. Sodium bicarbonate and potassium supplementation successfully treated severe bulbar, respiratory, and limb paralysis in a 22-year-old woman with distal renal tubular acidosis.
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