원위 신세뇨관성 산증을 유발한 파라콰트 중독 1예

Abstract

Distal Renal tubular acidosis is characterized by tubular dysfunction with a decrease in net H+-secretion in the collecting tubules regardless of normal glomerular filtration rate. It classified into primary and secondary form. The causes of secondary form could be many drugs such as amphotericin B, toluene, lithium carbonate, ifosfamide, but paraquat has not been reported. The mechanism of renal damage by paraquat has not be fully comprehensive but it is thought that paraquat causes damage to renal proximal tubules and clinically induces acute tubular necrosis. Our case demonstrated that immunohistochemical staining of renal biopsy specimen with anti H+-ATPase antibody showed absence of proton pump in collecting duct. Thus a case of distal renal tubular acidosis in association with paraquat intoxication is reported with a review of literatures.