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Pediatric Emergency Care:
doi: 10.1097/PEC.0b013e31824957cb
Illustrative Cases

Concomitant Hypercalcemia and Hyperammonemia Associated With Distal Renal Tubular Acidosis

Saini, Arun MD*; Karmakar, Swati A. MD*; Kannikeswaran, Nirupama MD*†

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Abstract

Abstract: We describe an infant with concomitant hypercalcemia and hyperammonemia associated with nonanion gap metabolic acidosis secondary to distal renal tubular acidosis (dRTA). The levels of both serum calcium and ammonia rapidly normalized with the correction of dehydration and metabolic acidosis. To the best of our knowledge, there has been only one previous case report of concomitant hypercalcemia and hyperammonemia associated with dRTA that has been reported in the literature. We describe the causes and emergent management of hypercalcemia and review the possible mechanisms of this rare association with dRTA.

© 2012 Lippincott Williams & Wilkins, Inc.

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