Type 1 renal tubular acidosis presenting with recurrent hypokalaemia paralysis

Type 1 renal tubular acidosis (RTA) is a metabolic disease characterised by hypokalaemia, hyperchloremic metabolic acidosis and urine pH above 5.5. These findings may be accompanied by hypercalciuria, nephrocalcinosis, nephrolithiasis, jaundice, osteomalacia or rickets in children. Although hypokalaemia is frequently seen as a laboratory finding in Type 1 RTA, weakness, which is the clinical finding of this deficiency, is rare. A 60-year-old female patient was brought to the emergency department with complaints of weakness, loss of strength in the extremities and difficulty in breathing. Laboratory analyses of the patient revealed metabolic acidosis and hypokalaemia. Urea and creatinine values were normal. The patient was admitted to the internal medicine department with a preliminary diagnosis of Type 1 RTA and hypokalaemic paralysis. Initially, parenteral infusion of KCl and NaHCO3 was administered in the treatment. In the follow-up of the patient, it was observed that hypokalaemia and metabolic acidosis improved within 48 h following the replacement therapy. Type 1 RTA, which is rare in adults, is among the secondary causes of hypokalaemic paralysis. Type 1RTA should be considered among the differential diagnoses in the presence of hypokalaemia and metabolic acidosis in patients presenting with bilateral weakness.