We report an unusual case of a 4-year-old girl presenting with recurrent episodes of weakness with documented hypokalemia, failure to thrive, and rachitic changes. Nerve conduction study during the episode of weakness revealed reduced compound muscle action potential amplitudes and motor conduction velocity and electromyography revealed reduced interference pattern, which normalized on correction of hypokalemia and subsequent recovery of weakness. The child was diagnosed with distal renal tubular acidosis. Ultrasound revealed medullary nephrocalcinosis, which regressed on long-term treatment with alkali and potassium supplement.
Keywords
distal renal tubular acidosis - quadriparesis - rickets - electrophysiological changes - nephrocalcinosis