Abstract
We present a case of distal renal tubular acidosis and acute renal insufficiency in a patient with Waldenström’s macroglobulinemia. Distal renal tubular acidosis has been described in hypergammaglobulinemia, but not in patients with Waldenström’s macroglobulinemia. To our knowledge, this is the first report to describe a possible association between distal renal tubular acidosis and Waldenström’s macroglobulinemia. Our case also emphasizes the importance of prompt recognition of distal renal tubular acidosis in patients with Waldenström’s macroglobulinemia because of its metabolic disturbances and potentially life threatening complications.
Highlights
Waldenström’s macroglobulinemia is a lymphoproliferative disease characterized by the excessive production of IgM monoclonal protein
We present a case of distal renal tubular acidosis and acute renal insufficiency in a patient with Waldenström’s macroglobulinemia
Distal renal tubular acidosis has been described in hypergammaglobulinemia, but not in patients with Waldenström’s macroglobulinemia
Summary
Waldenström’s macroglobulinemia is a lymphoproliferative disease characterized by the excessive production of IgM monoclonal protein. Distal renal tubular acidosis (RTA) has been described in hypergammaglobulinemia [6,7], but not in patients with Waldenström’s macroglobulinemia. We present a case of long-standing distal renal tubular acidosis (RTA) in a patient with Waldenström’s macroglobulinemia who came to our hospital because of acute renal dysfunction. Case presentation An 84-year old Caucasian female was admitted to our hospital with muscle cramps and increasing lethargy during the past few days Her medical history was significant for Waldenström’s macroglobulinemia, hypertension, paroxysmal atrial fibrillation, hyperlipidemia, and chronic kidney disease. Cases Journal 2009, 2:7198 http://casesjournal.com/casesjournal/article/view/7198 hyperchloremic non-anion gap metabolic acidosis and high urinary pH, suggestive of distal RTA. She has progressively developed nephrocalcinosis and renal dysfunction. Follow-up tests 2 weeks later, revealed a persistent hyperchloremic metabolic acidosis suggestive of distal renal tubular acidosis
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