Hyperglobulinemic Renal Tubular Acidosis
Authors: DONNA K. MCCURDY
Journal: Annals of Internal Medicine (1967)

Case Studies1 July 1967Hyperglobulinemic Renal Tubular AcidosisReport of Two CasesDONNA K. MCCURDY, M.D., GIBBONS G. CORNWELL III, M.D., VICTOR J. DEPRATTI, M.D.DONNA K. MCCURDY, M.D.Search for more papers by this author, GIBBONS G. CORNWELL III, M.D.Search for more papers by this author, VICTOR J. DEPRATTI, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-67-1-110 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptRenal tubular acidosis is a syndrome in which a specific inability of the renal tubule to lower urine pH normally is associated with renal bicarbonate wastage and, ultimately, hyperchloremic acidosis. Other common but by no means invariable manifestations of the syndrome include hypokalemia due to renal potassium wastage, nephrolithiasis and nephrocalcinosis, a vasopressin-resistant nephrogenic diabetes insipidus, hypercalciuria, decreased citrate excretion, and osteomalacia (1-4). Although the primary form of this syndrome occurs both familially and sporadically, unassociated with other diseases, secondary renal tubular acidosis may develop in the course of a number of disease states that in various ways may lead...References1. ALBRIGHTBURNETTPARSONREIFENSTEINROOS FCHWECA: Osteomalacia and late rickets. Medicine (Balt.) 25: 399, 1946. CrossrefMedlineGoogle Scholar2. WRONGDAVIES OHE: The excretion of acid in renal disease. Quart. J. Med. 28: 259, 1959. MedlineGoogle Scholar3. DEDMONWRONG REO: The excretion of organic anion in renal tubular acidosis with particular reference to citrate. Clin. Sci. 22: 19, 1962. MedlineGoogle Scholar4. ELKINTON JR: Renal acidosis: diagnosis and treatment. Med. Clin. N. Amer. 47: 935, 1963. CrossrefGoogle Scholar5. SIROTAHAMERMAN JHD: Renal function studies in an adult subject with the Fanconi syndrome. Amer. J. Med. 16: 138, 1954. CrossrefMedlineGoogle Scholar6. MORRISJOHNSONFUDENBERG CLHH: Studies on renal acidification in hyperglobulinemic, non-myelomatous states (abstract). J. Clin. Invest. 43: 1293, 1964. Google Scholar7. READSHERLOCKHARRISON AESCV: Active "juvenile" cirrhosis considered as part of a systemic disease and the effect of corticosteroid therapy. Gut 4: 378, 1963. CrossrefMedlineGoogle Scholar8. SEEDATRAINE YKER: Active chronic hepatitis associated with renal tubular acidosis and successful pregnancy. South Afr. Med. J. 39: 595, 1965. MedlineGoogle Scholar9. COHENWAY ABJ: The association of renal tubular acidosis with hyperglobulinaemic purpura. Aust. Ann. Med. 11: 189, 1962. MedlineGoogle Scholar10. WILSONWILLIAMSTOBIAN IDRCL: Renal tubular acidosis: immuno abnormalities in 3 patients and their kindreds (abstract). Clin. Res. 14: 449, 1966. Google Scholar11. SHEARNTU MAWH: Nephrogenic diabetes insipidus and other defects of renal tubular function in Sjögren's syndrome. Amer. J. Med. 39: 312, 1965. CrossrefMedlineGoogle Scholar12. LOSPALLUTODORWARDMILLERZIFF JBWM: Cryoglobulinemia based on interaction between a gamma macroglobulin and 7S gamma globulin. Amer. J. Med. 32: 142, 1962. CrossrefMedlineGoogle Scholar13. MORRISFUDENBERG RCHH: Impaired renal acidification in patients with hypergammaglobulinemia. Medicine (Balt.) 46: 57, 1967. CrossrefMedlineGoogle Scholar14. ELKINTONHUTHWEBSTERMCCANCE JREJGDRA: Renal excretion of hydrogen ion in renal tubular acidosis. I. Quantitative assessment of response to ammonium chloride as an acid load. Amer. J. Med. 29: 554, 1960. CrossrefMedlineGoogle Scholar15. ELKINTONMCCURDYBUCKALEW JRDKVM: Hydrogen ion and the kidney, in Renal Disease, 2nd ed., edited by BLACK, D. A. K. F. A. Davis Co., Philadelphia, in press, 1967. Google Scholar16. GOLDBERG M: Abnormalities in the renal excretion of water. Pathophysiology and differential diagnosis. Med. Clin. N. Amer. 47: 915, 1963. CrossrefMedlineGoogle Scholar17. REYNOLDS TB: Observations on the pathogenesis of renal tubular acidosis. Amer. J. Med. 25: 503, 1958. CrossrefMedlineGoogle Scholar18. MORRIS RC: Evidence for an acidification defect of the proximal renal tubule in experimental and clinical renal disease (abstract). J. Clin. Invest. 45: 1048, 1966. Google Scholar19. ENGLEWALLIS RLLA: Multiple myeloma and the adult Fanconi syndrome. Amer. J. Med. 22: 5, 1957. CrossrefMedlineGoogle Scholar20. DRAGSTEDHJORTH PJN: The association of the Fanconi syndrome with malignant disease. Danish Med. Bull. 3: 177, 1956. MedlineGoogle Scholar21. MUTENDAM H: Multipele myelomatosis en het syndroom van de Ton-Fanconi. Nederl. T. Geneesk. 102: 1690, 1958. MedlineGoogle Scholar22. DEDMONWESTSCHWARTZ REJHTB: The adult Fanconi syndrome. Report of two cases, one with multiple myeloma. Med. Clin. N. Amer. 47: 191, 1963. CrossrefMedlineGoogle Scholar23. SHORTSMITH IAJP: Myelomatosis associated with glycosuria and aminoaciduria. Scot. Med. J. 4: 89, 1959. CrossrefMedlineGoogle Scholar24. COSTANZASMOLLER DJM: Multiple myeloma with the Fanconi syndrome. Amer. J. Med. 34: 125, 1963. CrossrefGoogle Scholar25. HARRISONBLAINEY JFJD: Adult Fanconi syndrome with monoclonal abnormality of immunoglobulin light chain. J. Clin. Path. 20: 42, 1967. CrossrefMedlineGoogle Scholar26. EVANSMILNE BMMD: Potassium losing nephritis presenting as a case of periodic paralysis. Brit. Med. J. 2: 1067, 1954. CrossrefMedlineGoogle Scholar27. FOURMANMCCANCE PRA: Tetany complicating the treatment of potassium deficiency in renal acidosis. Lancet 1: 329, 1955. CrossrefGoogle Scholar28. MAHLERSTANBURY RFSW: Potassium losing renal disease. Quart. J. Med. 49: 21, 1956. Google Scholar29. Clinicopathologic conference: Recurrent renal lithiasis complicated by severe bleeding, anemia, and thrombopenia. Amer. J. Med. 39: 261, 1965. Google Scholar30. GREENSPAN EM: Hyperchloremic acidosis and nephrocalcinosis. Arch. Intern. Med. (Chicago) 83: 271, 1949. CrossrefGoogle Scholar31. PINESMUDGE KLGH: Renal tubular acidosis with osteomalacia. Report of three cases. Amer. J. Med. 11: 302, 1951. CrossrefMedlineGoogle Scholar32. LERNERBRICKNER BAPW: Renal tubular acidosis and potassium loss. Amer. J. Med. 27: 664, 1959. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: DONNA K. MCCURDY, M.D.; GIBBONS G. CORNWELLIII, M.D.; VICTOR J. DEPRATTI, M.D.Affiliations: Philadelphia, PennsylvaniaFrom the Renal-Electrolyte and Hematology Sections, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pa.This work was supported by grants 5 R01 HE00340-18, 5R01 HE-07284-04, 05, and 5M01, FR 40-07, the U. S. Public Health Service, Washington, D. C.Drs. Cornwell and DePratti were Trainees in Hematology supported by training grant TI AM 5228, the U. S. Public Health Service.Requests for reprints should be addressed to Donna K. McCurdy, M.D., 860 Gates Bldg., Hospital of the University of Pennsylvania, Philadelphia, Pa. 19104. 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CURTIS MORRIS JR., M.D.Defective Urinary Acidification in Wilson's DiseaseMILFORD FULOP, M.D., IRMIN STERNLIEB, M.D., I. HERBERT SCHEINBERG, M.D.Renal Tubular Syndromes, Immunologic Disorders, and CancerE. J. H. 1 July 1967Volume 67, Issue 1 Page: 110-117 Keywords Biopsy Excretion Factor analysis Hematology and oncology Medical services Potassium Renal analysis Renal diseases Serum proteins Urine ePublished: 1 December 2008 Issue Published: 1 July 1967 PDF downloadLoading ...