Systemic lupus erythematosus associated with type 4 renal tubular acidosis: a case report and review of the literature.

Type 4 renal tubular acidosis is an uncommon clinical manifestation of systemic lupus erythematosus and has been reported to portend a poor prognosis. To the best of our knowledge, this is the first case report which highlights the successful management of a patient with systemic lupus erythematosus complicated by type 4 renal tubular acidosis who did not do poorly. A 44-year-old Hispanic woman developed a non-anion gap hyperkalemic metabolic acidosis consistent with type 4 renal tubular acidosis while being treated in the hospital for recently diagnosed systemic lupus erythematosus with multi-organ involvement. She responded well to treatment with corticosteroids, hydroxychloroquine and mycophenolate mofetil. Normal renal function was achieved prior to discharge and remained normal at the patient's one-month follow-up examination. This case increases awareness of an uncommon association between systemic lupus erythematosus and type 4 renal tubular acidosis and suggests a positive impact of early diagnosis and appropriate immunosuppressive treatment on the patient's outcome.

Citation

Haldane Porteous, Nadia Morgan, Julio Lanfranco, Monica Garcia-Buitrago, Larry Young, Oliver Lenz. Systemic lupus erythematosus associated with type 4 renal tubular acidosis: a case report and review of the literature. Journal of medical case reports. 2011;5:114

PMID: 21435204

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