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KMID : 0606620080040030231
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Korean Journal of Fetal Medicine
2008 Volume.4 No. 3 p.231 ~ p.237
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A Case of Hypokalemic Paralysis During Pregnancy in a Patient With Systemic Lupus Erythematosus Complicated With Renal Tubular Acidosis
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Kim Yeon-Hee
Jun Chung-Ra
Shin Jong-Chul
Park Tae-Chul
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Abstract
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Renal tubular acidosis in pregnancy, a very rare disorder, is caused by an inability of distal tubules of kidney to excrete hydrogen ions. This results in significant systemic acidosis, hypokalemia, hypocalcemia, and hypercalciuria. Various tubular defects, such as interstitial tubulonephritis, can be associated with systemic lupus erythematosus and often lead to distal renal tubular acidosis. In a pregnant patient with autoimmune disease, anti SS-A/SS-B antibodies can damage the cardiac conductive system of the fetus and cause the congenital heart block or hydrops. We report a 38-year-old multiparous woman, referred at 27weeks of gestational age because of a maternal flaccid paralysis, muscle tenderness and respiratory depression, and non reassuring fetal heart beats. It was proven that the renal tubular acidosis with systemic lupus erythematosus with positive anti SS-A/SS-B antibodies and fetal complete heart block without structural cardiac defect by performing maternal blood test, fetal echocardiography and autopsy.
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KEYWORD
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Distal renal tubular acidosis, Systemic lupus erythematosus, Fetal complete heart block
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