Abstract 74: Proximal renal tubular acidosis with rickets: A case report

A 18 year old male presented to Endocrinology OPD with a 13 year old history of difficulty in walking and knee deformity. He had a 4-year-old history of scrotal swelling. Despite having done corrective surgery, the deformity was refractory and again reverted in the last 5 years. The remaining physical examination was unremarkable. Upon detail history and evaluation, his Sexual Maturity Rating was around 4-5 with Vitamin D Deficiency. Patient's intact PTH was 468 pg/ml. Radiological evaluation was showing decreased bone density and valgus deformity of knee. Patient's Urine routine came was significantly acidic and upon administration of steroid improvement was seen. This gave a rare presentation of Rickets with Proximal RTA and Hyperparathyroidism. Patient was evaluated and followed up with vitamin and mineral supplementation. The relation of antagonizing factors disrupting the equilibrium between parathyroid hormone and calcium at tubular level is clinically scarcely reported. Active follow up and prompt, effective treatment is vital in such cases.