HIV Infection Itself may be a Cause of Hypokalemic Distal Renal Tubular Acidosis without Hypergammaglobulinemia.
Loading...
Date
2014-01-01
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Distal renal tubular acidosis (dRTA) is seen in the human immunodeficiency
virus/acquired immunodeficiency syndrome (HIV/AIDS) population in the setting of
hypergammaglobulinemia and antiretroviral agents, whereas isolated HIV infection is
rarely reported to be associated with dRTA. We report a case of a young woman with a
history of untreated HIV/AIDS who presented with profound generalized weakness and
refractory hypokalemia along with non-anion gap metabolic acidosis and inappropriately
high urine pH. Her serum gamma-globulin level was not significantly elevated and she
was not on highly active antiretroviral therapy (HAART). No other cause of dRTA was
evident. Subsequently, a diagnosis of dRTA secondary to isolated HIV/AIDS was made.
Distal RTA can be acquired or inherited and is caused by defects in proton pumps or pH
pressure gradients. In dRTA, the potassium level can be low, normal, or even high
depending upon the pathophysiologic abnormality. Early recognition and prompt treatment is imperative to avoid the serious consequences of severe electrolyte and
metabolic disturbances. Our case report is a reminder to clinicians to be mindful of this
rare condition when evaluating unexplained dRTA and to include HIV/AIDS as part of the
differential diagnosis of dRTA even in the absence of significant
hypergammaglobulinemic (IgG level was slightly elevated) state or antiretroviral agents.
We believe this is the second such case to be documented.
Description
Keywords
Distal renal tubular acidosis, HIV, Hypergammaglobulinemia, non anion gap metabolic acidosis
Citation
Akbar Ghulam, Feng Ji-An, Abbas Naeem, Thiruveedi Sampath, Teehan Geoffrey S, Burhan Umber. HIV Infection Itself may be a Cause of Hypokalemic Distal Renal Tubular Acidosis without Hypergammaglobulinemia.British Journal of Medicine and Medical Research. 2014 Jan; 4(1): 522-528.