PMID: 44068Nov 1, 1979

Congenital persistent proximal type renal tubular acidosis in two brothers

Acta paediatrica Scandinavica
A WinsnesT Feyling


Two brothers showed severe and persistent hyperchloraemic metabolic acidosis (capillary blood pH 7.07--7.15) due to a low renal bicarbonate threshold at 11 mmol/l. The maximal tubular capacity for bicarbonate reabsorption was reduced to about half the normal. A high dose of acetazolamide (25 mg/kg) lowered the tubular bicarbonate reabsorption substantially, indicating the presence of carbonic anhydrase. Both the glomerular filtration rate, the renal blood flow and the renal concentrating capacity were slightly reduced. The clinical characteristics were: growth retardation, mental retardation, nystagmus, corneal opacities, cataract, glaucoma and enamel defects of the permanent teeth. Serum thyroxine was pathological low without clinical signs of hypothyreosis. The erythrocytes showed an increased osmotic resistance. Autopsy of the younger brother, who died 4 1/2 years old, revealed thyroid and thymus weights of 25% of the normal. The kidney tubular cells were swollen with vacuoles. The glomeruli had a normal appearance.


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Related Concepts

Acetazolamide Sodium, (Sterile)
Renal Tubular Acidosis
Renal Tubular Acidosis, Type II
Fetal Growth Retardation
Carbonic Acid Ions
Anion Gap
Congenital Nystagmus
Corneal Opacity

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