A case of 45-year-old female complaining of both shoulders, both hips and low back pain with gait disturbance, was reported.
On the X-ray examination, typical osteomalacic bone changes with Looser's zones were seen. On the biochemical examination, hypokalemia, hypophosphatemia, hyperchloremia and metabobic acidosis were found. Furtheremore sero-immunologically γ-globulin was increased moderately, and RA test was positive. From the findings of renal function test and NH4Cl loading test, this case was diagnosed as Type 1 (secondary) renal tubular acidosis.
Acidosis was corrected with Shohl's solution and depletion of kalium was supplemented with potassium gluconate. Coxa vara deformities were corrected by intertrochanteric valgus osteotomies, and now patient became ambulant without crutches.
