Distal Renal Tubular Acidosis Presenting as Recurrent Paralytic Crises A Case Report

Renal tubular acidosis (RTA) is a syndrome resulting from tubular dysfunction leading to deranged acid-base balance. One of the subtypes, distal RTA manifests as renal parenchymal stone disease with nephrocalcinosis, evidence of vitamin D deficiency and growth faltering in children with ultimate short stature in adulthood. The physician should be familiar with the condition, in order to expedite correct management and ameliorate the complications. We hereby report a case of distal renal tubular acidosis (dRTA), who presented with recurrent hypokalemic paralysis and osteopenia but, unusually, without any nephrocalcinosis. [Med-Science 2015; 4(4.000): 2933-7

Nell1 as Target Antigen for Mercury Related Membranous Nephropathy: A Case Report

Membranous nephropathy constitutes 30% of adult nephrotic syndrome. Of all cases of membranous nephropathy, primary membranous nephropathy is commonest. Mercury is known to be a cause of secondary membranous nephropathy. There is no human data on the pathophysiology of mercury-related membranous nephropathy, but animal studies suggested an autoimmune mechanism behind it. There is no data to the best of our knowledge about target antigen for mercury-related membranous nephropathy. We are reporting a case of NELL-1 positive mercury-related membranous nephropathy that started resolving after stopping siddha medication and taking antiproteinuric. There was also concomitant euthyroid lymphocytic thyroiditis with anti-TPO positive, which started after exposure to siddha medication, which suggests systemic autoimmune phenomenon due to mercury exposure