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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Systemic lupus erythematosus associated with type 4 renal tubular acidosis: a case report and review of the literature. | Porteous et al. Journal of Medical Case Reports 2011 5 114 http www.jmedicalcasereports.eom content 5 1 114 JOURNALOF medical case reports CASE REPORT Open Access Systemic lupus erythematosus associated with type 4 renal tubular acidosis a case report and review of the literature Haldane Porteous1 Nadia Morgan2 Julio Lanfranco1 Monica Garcia-Buitrago3 Larry Young4 and Oliver Lenz5 Abstract Introduction 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. Case presentation 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. Conclusion 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. Introduction Inability of the kidney either to excrete sufficient net acid or to retain sufficient bicarbonate results in a group of disorders known as renal tubular acidoses RTAs 1 . These are normal anion gap hyperchloremic acidoses. In the traditional classification type 4 is the only variant associated with hyperkalemia. Compared to the other distal RTAs in type 4 RTA the collecting duct fails to excrete both protons and potassium. Such a scenario arises when there