Two cases of Hypokalemic Paralysis due to Distal Renal Tubular Acidosis

Abstract

Hypokalemic periodic paralysis is a rare disorder characterized by transient attacks of flaccid paralysis of varying intensity and frequency. Although mostly familial in etiology, several sporadic cases have been reported, including some resulting from renal tubular acidosis. Here we present two cases, first of a 55 yr. old woman with recurrent attacks of flaccid paralysis, and the second, of a 16 yr. Old girl who presented with flaccid quadriparesis with no similar history in the past, both of whom on evaluation turned out to be secondary hypokalemic periodic paralysis caused by Distal Renal Tubular Acidosis (RTA). As the clinical appearance of hypokalemic paralysis distal RTA is quite similar to Familial Hypokalemic Periodic Paralysis (FPP), and because the emergent and prophylactic treatment of the two disorders is quite different, we discuss the diagnostic evaluation and the treatment of distal renal tubular acidosis.