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Int. Rev. Allergol. Clin. Immunol. Family Med., 2014, XX/2: 078-081 Maximize

Int. Rev. Allergol. Clin. Immunol. Family Med., 2014, XX/2: 078-081

Title: Case of young woman with Graves’ disease and incomplete distal renal tubular acidosis with severe progress and cardiac arrest

/ Authors: Klimm W., Kade G., Spaleniak S., Dubchak I., Niemczyk S.

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04-02-2014

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SUMMARY IN POLISH & ENGLISH. FULL ARTICLE ONLY IN POLISH.

Case of young woman with Graves’ disease and incomplete distal renal tubular acidosis with severe progress and cardiac arrest

Klimm W., Kade G., Spaleniak S., Dubchak I., Niemczyk S.


Military Institute of Medicine in Warsaw, Poland, Department of Internal Diseases, Nephrology and Dialyses, Central Clinical Hospital of the Ministry of National Defense

Int. Rev. Allergol. Clin. Immunol. Family Med., 2014; Vol. 20, No. 2, 78

Diagnostic of renal tubular disorders can be often difficult. Incomplete form of distal Renal Tubular Acidosis (dRta) in course of Graves’ disease was de novo recognized in a young woman hospitalized with a deep deficiency of potassium in blood serum complicated with cardiac arrest. Series of tests assessing the types and severity of water-electrolyte, acid-base and thyroid disorders were performed during a complex diagnosis. During the treatment of acute phase of the disease we intensified efforts to maintain basic life functions and to eliminate deep waterelectrolyte disturbances. In the second phase of the treatment we determined an underlying cause of the disease, recognized dRTA, and introduced a specific long-term electrolyte and hormonal therapy. To confirm the diagnosis oral test with ammonium chloride (Wrong-Davies’ test) was performed. After completion of the diagnostic and therapeutic process, the patient was included in the nephrological supervision on an outpatient basis. The basic drug for the therapy was sodium citrate. After a year of observation and continuing treatment we evaluated therapeutic results as good and permanent.

Key words: renal acidosis, hypokalemia, renal failure, hyperthyreosis, Graves’ disease