Preview

Russian Pediatric Journal

Advanced search

A CLINICAL CASE OF RENAL TUBULAR ACIDOSIS (TYPE III) IN AN INFANT

https://doi.org/10.46563/1560-9561-2021-24-1-61-65

Abstract

Tubulopathy is accompanied by electrolyte imbalance due to impaired excretion of hydrogen ions (type I), impaired reabsorption of bicarbonates (type II), abnormal aldosterone production, or interaction with it (IV). The course can be asymptomatic or with manifestations of electrolyte disorders: weakness, nausea, bone deformities. Diagnosis of renal acidemia is based on measurements of urine pH and electrolytes, data from genetic tests. A clinical case of renal tubular acidosis (type III) in an infant. The article presents the clinical picture of renal tubular acidosis, its classification, and diagnostics in children. Authors consider the importance of applying modern research methods to conduct timely treatment and improve the patients’ lives.

About the Authors

N. A. Kharitonova
National Medical Research Center for Children’s Health
Russian Federation


M. A. Basargina
National Medical Research Center for Children’s Health
Russian Federation


P. V. Ananin
National Medical Research Center for Children’s Health
Russian Federation


Kh. S. Evloeva
National Medical Research Center for Children’s Health
Russian Federation


References

1. Pelletier J., Gbadegesin R., Staples B. Renal tubular acidosis. Pediatr. Rev. 2017; 38(11): 537-9. https://doi.org/10.1542/pir.2016-0231

2. Вашурина Т.В., Сергеева Т.В. Ренальный тубулярный ацидоз. Нефрология и диализ. 2003; 5(2): 122-7

3. Kashoor I., Batlle D. Proximal renal tubular acidosis with and without Fanconi syndrome. Kidney Res. Clin. Pract. 2019; 38(3): 267-81. https://doi.org/10.23876/j.krcp.19.056

4. McSherry E., Sebastian A., Morris R.C. Renal tubular acidosis in infants: the several kinds, including bicarbonate-wasting, classic renal tubular acidosis. J. Clin Invest. 1972; 51(3): 499-514. https://doi.org/10.1172/jci106838

5. Kamel K.S., Briceno L.F., Sanchez M.D. A new classification for renal defects in net acid excretion. Am. J. Kidney Dis. 1997; 29(1): 136-46. https://doi.org/10.1016/s0272-6386(97)90021-4

6. Rodrigues-Soriano J., Vallo A. Renal tubular acidosis. Pediatr. Nephrol. 1990; 4(3): 268-75. https://doi.org/10.1007/BF00857675

7. Caldas A., Broyewr M., Dechaux M., Kleinknecht C. Primary distal tubular acidosis in childhood: Clinical study and long-term follow-up of 28 patients. J. Pediatr. 1992; 121(2): 233-41. https://doi.org/10.1016/s0022-3476(05)81194-1

8. Batlle D., Ghanekar H., Jain S., Mitra A. Hereditary distal renal tubular acidosis: new understandings. Annu. Rev Med. 2001; 52: 471-84. https://doi.org/10.1146/annurev.med.52.1.471

9. Foreman J.W. Fanconi Syndrome. Pediatr. Clin. North Am. 2019; 66(1): 159-67. https://doi.org/10.1016/j.pcl.2018.09.002

10. Igarashi T., Sekine T., Inatomi J., Seki G. Unraveling the molecular pathogenesis of isolated proximal renal tubular acidosis. J. Am. Soc. Nephrol. 2002; 13(8): 2171-7. https://doi.org/10.1097/01.asn.0000025281.70901.30

11. Supuran C.T. Carbonic anhydrases - an overview. Curr. Pharm. Des. 2008; 14(7): 603-14. https://doi.org/10.2174/138161208783877884

12. DuBose T.D. Hyperkalemic hyperchloremic metabolic acidosis: pathophysiologic insights. Kidney Int. 1997; 51(2): 591-602. https://doi.org/10.1038/ki.1997.85

13. Sly W.S., Hewett-Emmett D., Whyte M.P., Yu Y.S.L., Tashian R.E. Carbonic anhydrase II deficiency identified as the Primary defect in the autosomal recessive syndrome of osteoporosis with renal tubular acidosis and cerebral calcification. Proc. Natl Acad. Sci. USA. 1983; 80(9): 2752-6. https://doi.org/10.1073/pnas.80.9.2752

14. Lotan D., Eisenkraft A., Jacobsson J.M. Clinical and molecular findings in a family with the carbonic anhydrase II deficiency syndrome. Pediatr. Nephrol. 2006; 21(3): 423-6. https://doi.org/10.1007/s00467-005-2125-0

15. Sly W.S., Shah G.N., Bonapace G., Hu P.Y., Strisciuglio P. Carbonic anhydrase II deficiency syndrome (osteopetrosis with renal tubular acidosis and brain calcification): novel mutations in CA2 identified by direct sequencing expand the opportunity for genotype-phenotype correlation. Hum. Mutat. 2004; 24(3): 272. https://doi.org/10.1002/humu.9266

16. Whyte M.P. Carbonic anhydrase II deficiency. Clin. Orthop. Relat. Res. 1993; (294) 52-63.

17. Strisciuglio P., Sartorio R., Pecoraro C., Lotito F., Sly W.S. Variable clinical presentation of carbonic anhydrase deficiency: Evidence for heterogeneity? Eur. J. Pediatr. 1990; 149(5): 337-40. https://doi.org/10.1007/BF02171561

18. Alexander R.T., Bitzan M. Renal tubular acidosis. Pediatr. Clin. North Am. 2019; 66(1): 135-57. https://doi.org/10.1016/j.pcl.2018.08.011

19. Reddy Mh R. Osteopetrosis (marble bone disease): a rare disease in children. Int. J. Clin. Pediatr. Dent. 2011; 4(3): 232-4. https://doi.org/10.5005/jp-journals-10005-1115

20. Rodríguez Soriano J. Renal tubular acidosis: the clinical entity. J. Am. Soc. Nephrol. 2002; 13(8): 2160-70. https://doi.org/10.1097/01.asn.0000023430.92674.e5

21. Di Palmo E., Gallucci M., Tronconi E. Carbonic anhydrase II deficiency: A rare case of severe obstructive sleep apnea. Front. Pediatr. 2018; 6: 213. https://doi.org/10.3389/fped.2018.00213

22. Guibaud P., Larbre F., Freycon M.T., Genoud J. Osteopetrose et acidoserenaletubulaire: deuxcas de cette association dansunefratrie. Arch. Fr. Pediatr. 1972; 29(3): 269-86. (in French)

23. Shaik N.A., Bokhari H.A., Masoodi T.A., Shetty P.J., Ajabnoor G.M.A., Elango R., et al. Molecular modelling and dynamics of CA2 missense mutations causative to carbonic anhydrase 2 deficiency syndrome. J. Biomol. Struct. Dyn. 2020; 38(14): 4067-80. https://doi.org/10.1080/07391102.2019.1671899

24. Fathallah D.M., Bejaoui M., Lepaslier D., Chater K., Sly W.S., Dellagi K. Carbonic anhydrase II (CA II) deficiency in Maghrebian patients: evidence for founder effect and genomic recombination at the CA II locus. Hum. Genet. 1997; 99(5): 634-7. https://doi.org/10.1007/s004390050419

25. Hu P.Y., Roth D.E., Skaggs L.A., Venta P.J., Tashian R.E., Guibaud P., et al. A splice junction mutation in intron 2 of the carbonic anhydrase II gene of osteopetrosis patients from Arabic countries. Hum. Mutat. 1992; 1(4): 288-92. https://doi.org/10.1002/humu.1380010404

26. Fathallah D.M., Bejaoui M., Sly W.S., Lakhoua R., Dellagi K. A unique mutation underlying carbonic anhydrase II deficiency syndrome in patients of Arab descent. Hum. Genet. 1994; 94(5): 581-2. https://doi.org/10.1007/BF00211035

27. Cotter M., Connell T., Colhoun E., Smith O.P., McMahon C. Carbonic Anhydrase II Deficiency. A rare autosomal recessive disorder of osteopetrosis, renal tubular acidosis, and cerebral calcification. J. Pediatr. Hematol. Oncol. 2005; 27(2): 115-7. https://doi.org/10.1097/01.mph.0000154068.86987.47

28. Sh Ali A.A., Al-Mashta S.A. Cerebral calcification, osteopetrosis and renal tubular acidosis: is it carbonic anhydrase-II deficiency. Saudi J. Kidney Dis. Transpl. 2013; 24(3): 561-5. https://doi.org/10.4103/1319-2442.111067

29. Marks S.C. Morphological evidence of reduced bone resorption in osteopetrotic (op) mice. Am. J. Anat. 1982; 163(2): 157-67. https://doi.org/10.1002/aja.1001630205

30. Stark Z., Savarirayan R. Osteopetrosis. Orphanet J. Rare Dis. 2009; 4: 5. https://doi.org/10.1186/1750-1172-4-5

31. Nampoothiri S., Anikster Y. Carbonic anhydrase II deficiency a novel mutation. Indian Pediatr. 2009; 46(6): 532-4.

32. Strisciuglio P., Sartorio R., Pecoraro C., Lotito F., Sly W.S. Variable clinical presentation of carbonic anhydrase deficiency: Evidence for heterogeneity? Eur. J. Pediatr. 1990; 149(5): 337-40. https://doi.org/10.1007/bf02171561

33. Di Rocco M., Buoncompagni A., Loy A., Dellacqua A. Osteopetrorickets: Case report. Eur. J. Pediatr. 2000; 159(8): 579-81. https://doi.org/10.1007/s004310000485

34. Laway B.A., Mubarik I. Renal tubular acidosis, osteopetrosis, and cerebral calcification: a rare syndrome caused by carbonic anhydrase II deficiency. Indian J. Nephrol. 2017; 27(4): 330-1. https://doi.org/10.4103/0971-4065.209347

35. Awad M., Al-Ashwal A.A., Sakati N., Al-Abbad A.A., Bin-Abbas B.S. Long-term follow up of carbonic anhydrase II deficiency syndrome. Saudi Med. J. 2002; 23(1): 25-9.

36. Nagai R., Kooh S.W., Balfe J.W., Fenton T., Halperin M.L. Renal tubular acidosis and osteopetrosos with carbonic anhydrase II deficiency: Pathogenesis of impaired acidification. Pediatr. Nephrol. 1997; 11(5): 633-6. https://doi.org/10.1007/s004670050354

37. Pelletier J., Gbadegesin R., Staples B. Renal tubular acidosis. Pediatr. Rev. 2017; 38(11): 537-9. https://doi.org/10.1542/pir.2016-0231

38. Вашурина Т.В., Сергеева Т.В. Ренальный тубулярный ацидоз. Нефрология и диализ. 2003; 5(2): 122-7

39. Kashoor I., Batlle D. Proximal renal tubular acidosis with and without Fanconi syndrome. Kidney Res. Clin. Pract. 2019; 38(3): 267-81. https://doi.org/10.23876/j.krcp.19.056

40. McSherry E., Sebastian A., Morris R.C. Renal tubular acidosis in infants: the several kinds, including bicarbonate-wasting, classic renal tubular acidosis. J. Clin Invest. 1972; 51(3): 499-514. https://doi.org/10.1172/jci106838

41. Kamel K.S., Briceno L.F., Sanchez M.D. A new classification for renal defects in net acid excretion. Am. J. Kidney Dis. 1997; 29(1): 136-46. https://doi.org/10.1016/s0272-6386(97)90021-4

42. Rodrigues-Soriano J., Vallo A. Renal tubular acidosis. Pediatr. Nephrol. 1990; 4(3): 268-75. https://doi.org/10.1007/BF00857675

43. Caldas A., Broyewr M., Dechaux M., Kleinknecht C. Primary distal tubular acidosis in childhood: Clinical study and long-term follow-up of 28 patients. J. Pediatr. 1992; 121(2): 233-41. https://doi.org/10.1016/s0022-3476(05)81194-1

44. Batlle D., Ghanekar H., Jain S., Mitra A. Hereditary distal renal tubular acidosis: new understandings. Annu. Rev Med. 2001; 52: 471-84. https://doi.org/10.1146/annurev.med.52.1.471

45. Foreman J.W. Fanconi Syndrome. Pediatr. Clin. North Am. 2019; 66(1): 159-67. https://doi.org/10.1016/j.pcl.2018.09.002

46. Igarashi T., Sekine T., Inatomi J., Seki G. Unraveling the molecular pathogenesis of isolated proximal renal tubular acidosis. J. Am. Soc. Nephrol. 2002; 13(8): 2171-7. https://doi.org/10.1097/01.asn.0000025281.70901.30

47. Supuran C.T. Carbonic anhydrases - an overview. Curr. Pharm. Des. 2008; 14(7): 603-14. https://doi.org/10.2174/138161208783877884

48. DuBose T.D. Hyperkalemic hyperchloremic metabolic acidosis: pathophysiologic insights. Kidney Int. 1997; 51(2): 591-602. https://doi.org/10.1038/ki.1997.85

49. Sly W.S., Hewett-Emmett D., Whyte M.P., Yu Y.S.L., Tashian R.E. Carbonic anhydrase II deficiency identified as the Primary defect in the autosomal recessive syndrome of osteoporosis with renal tubular acidosis and cerebral calcification. Proc. Natl Acad. Sci. USA. 1983; 80(9): 2752-6. https://doi.org/10.1073/pnas.80.9.2752

50. Lotan D., Eisenkraft A., Jacobsson J.M. Clinical and molecular findings in a family with the carbonic anhydrase II deficiency syndrome. Pediatr. Nephrol. 2006; 21(3): 423-6. https://doi.org/10.1007/s00467-005-2125-0

51. Sly W.S., Shah G.N., Bonapace G., Hu P.Y., Strisciuglio P. Carbonic anhydrase II deficiency syndrome (osteopetrosis with renal tubular acidosis and brain calcification): novel mutations in CA2 identified by direct sequencing expand the opportunity for genotype-phenotype correlation. Hum. Mutat. 2004; 24(3): 272. https://doi.org/10.1002/humu.9266

52. Whyte M.P. Carbonic anhydrase II deficiency. Clin. Orthop. Relat. Res. 1993; (294) 52-63.

53. Strisciuglio P., Sartorio R., Pecoraro C., Lotito F., Sly W.S. Variable clinical presentation of carbonic anhydrase deficiency: Evidence for heterogeneity? Eur. J. Pediatr. 1990; 149(5): 337-40. https://doi.org/10.1007/BF02171561

54. Alexander R.T., Bitzan M. Renal tubular acidosis. Pediatr. Clin. North Am. 2019; 66(1): 135-57. https://doi.org/10.1016/j.pcl.2018.08.011

55. Reddy Mh R. Osteopetrosis (marble bone disease): a rare disease in children. Int. J. Clin. Pediatr. Dent. 2011; 4(3): 232-4. https://doi.org/10.5005/jp-journals-10005-1115

56. Rodríguez Soriano J. Renal tubular acidosis: the clinical entity. J. Am. Soc. Nephrol. 2002; 13(8): 2160-70. https://doi.org/10.1097/01.asn.0000023430.92674.e5

57. Di Palmo E., Gallucci M., Tronconi E. Carbonic anhydrase II deficiency: A rare case of severe obstructive sleep apnea. Front. Pediatr. 2018; 6: 213. https://doi.org/10.3389/fped.2018.00213

58. Guibaud P., Larbre F., Freycon M.T., Genoud J. Osteopetrose et acidoserenaletubulaire: deuxcas de cette association dansunefratrie. Arch. Fr. Pediatr. 1972; 29(3): 269-86. (in French)

59. Shaik N.A., Bokhari H.A., Masoodi T.A., Shetty P.J., Ajabnoor G.M.A., Elango R., et al. Molecular modelling and dynamics of CA2 missense mutations causative to carbonic anhydrase 2 deficiency syndrome. J. Biomol. Struct. Dyn. 2020; 38(14): 4067-80. https://doi.org/10.1080/07391102.2019.1671899

60. Fathallah D.M., Bejaoui M., Lepaslier D., Chater K., Sly W.S., Dellagi K. Carbonic anhydrase II (CA II) deficiency in Maghrebian patients: evidence for founder effect and genomic recombination at the CA II locus. Hum. Genet. 1997; 99(5): 634-7. https://doi.org/10.1007/s004390050419

61. Hu P.Y., Roth D.E., Skaggs L.A., Venta P.J., Tashian R.E., Guibaud P., et al. A splice junction mutation in intron 2 of the carbonic anhydrase II gene of osteopetrosis patients from Arabic countries. Hum. Mutat. 1992; 1(4): 288-92. https://doi.org/10.1002/humu.1380010404

62. Fathallah D.M., Bejaoui M., Sly W.S., Lakhoua R., Dellagi K. A unique mutation underlying carbonic anhydrase II deficiency syndrome in patients of Arab descent. Hum. Genet. 1994; 94(5): 581-2. https://doi.org/10.1007/BF00211035

63. Cotter M., Connell T., Colhoun E., Smith O.P., McMahon C. Carbonic Anhydrase II Deficiency. A rare autosomal recessive disorder of osteopetrosis, renal tubular acidosis, and cerebral calcification. J. Pediatr. Hematol. Oncol. 2005; 27(2): 115-7. https://doi.org/10.1097/01.mph.0000154068.86987.47

64. Sh Ali A.A., Al-Mashta S.A. Cerebral calcification, osteopetrosis and renal tubular acidosis: is it carbonic anhydrase-II deficiency. Saudi J. Kidney Dis. Transpl. 2013; 24(3): 561-5. https://doi.org/10.4103/1319-2442.111067

65. Marks S.C. Morphological evidence of reduced bone resorption in osteopetrotic (op) mice. Am. J. Anat. 1982; 163(2): 157-67. https://doi.org/10.1002/aja.1001630205

66. Stark Z., Savarirayan R. Osteopetrosis. Orphanet J. Rare Dis. 2009; 4: 5. https://doi.org/10.1186/1750-1172-4-5

67. Nampoothiri S., Anikster Y. Carbonic anhydrase II deficiency a novel mutation. Indian Pediatr. 2009; 46(6): 532-4.

68. Strisciuglio P., Sartorio R., Pecoraro C., Lotito F., Sly W.S. Variable clinical presentation of carbonic anhydrase deficiency: Evidence for heterogeneity? Eur. J. Pediatr. 1990; 149(5): 337-40. https://doi.org/10.1007/bf02171561

69. Di Rocco M., Buoncompagni A., Loy A., Dellacqua A. Osteopetrorickets: Case report. Eur. J. Pediatr. 2000; 159(8): 579-81. https://doi.org/10.1007/s004310000485

70. Laway B.A., Mubarik I. Renal tubular acidosis, osteopetrosis, and cerebral calcification: a rare syndrome caused by carbonic anhydrase II deficiency. Indian J. Nephrol. 2017; 27(4): 330-1. https://doi.org/10.4103/0971-4065.209347

71. Awad M., Al-Ashwal A.A., Sakati N., Al-Abbad A.A., Bin-Abbas B.S. Long-term follow up of carbonic anhydrase II deficiency syndrome. Saudi Med. J. 2002; 23(1): 25-9.

72. Nagai R., Kooh S.W., Balfe J.W., Fenton T., Halperin M.L. Renal tubular acidosis and osteopetrosos with carbonic anhydrase II deficiency: Pathogenesis of impaired acidification. Pediatr. Nephrol. 1997; 11(5): 633-6. https://doi.org/10.1007/s004670050354


Review

For citations:


Kharitonova N.A., Basargina M.A., Ananin P.V., Evloeva Kh.S. A CLINICAL CASE OF RENAL TUBULAR ACIDOSIS (TYPE III) IN AN INFANT. Russian Pediatric Journal. 2021;24(1):61-65. (In Russ.) https://doi.org/10.46563/1560-9561-2021-24-1-61-65

Views: 34


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1560-9561 (Print)
ISSN 2413-2918 (Online)