Firmin C J, Kruger T F, Davids R
Department of Obstetrics and Gynaecology, Tygerberg Hospital, University of Stellenbosch, Cape Town, South Africa.
Gynecol Obstet Invest. 2007;63(1):39-44. doi: 10.1159/000094942. Epub 2006 Aug 10.
Renal tubular acidosis is usually associated with chronic renal conditions and is rarely encountered in pregnancy. It may be inherited causing osteomalacia and rickets in children or acquired following autoimmune diseases or following exposure to nephrotoxic agents. It is known to worsen during pregnancy and if left untreated may cause maternal and foetal morbidity or death. We report a 28-year-old woman, gravida 3 para 2, who presented at 30 weeks gestation with lethargy, weakness and generalized myalgia. Investigation revealed severe hypokalaemia and a systemic metabolic acidosis due to proximal renal tubular acidosis. Her previous pregnancies were both complicated by foetal losses at term. Following prompt correction of her electrolyte disturbance and metabolic acidosis, she went on to deliver a healthy female infant at term. Regular evaluation up to 1 year post-partum revealed mild persistence of her hypokalaemia. At 1 year, the infant showed no signs of the disorder and is growing normally.
肾小管酸中毒通常与慢性肾脏疾病相关，在妊娠期间很少见。它可能是遗传性的，可导致儿童患骨软化症和佝偻病，也可能是在自身免疫性疾病后或接触肾毒性药物后获得的。已知其在妊娠期间会恶化，若不治疗可能导致母婴发病或死亡。我们报告一名28岁女性，孕3产2，在妊娠30周时出现嗜睡、乏力和全身肌痛。检查发现由于近端肾小管酸中毒导致严重低钾血症和全身性代谢性酸中毒。她之前的两次妊娠均在足月时出现胎儿丢失的并发症。在迅速纠正其电解质紊乱和代谢性酸中毒后，她足月分娩了一名健康女婴。产后长达1年的定期评估显示她的低钾血症仍有轻度持续。1岁时，婴儿未表现出该疾病的迹象，生长正常。
