Abstract

Chronic vitamin D deficiency when accompanied by renal tubular acidosis can cause several electrolyte imbalances that may present with weakness, pain and very rarely as tracheomalacia. Whereas Vitamin D deficiency has been documented as a cause of osteomalacia in literature, distal RTA or type 1 can only rarely present with disorders of bone metabolism. We herein report case of a 40 year old male patient who presented to us with respiratory failure and was found to have hypokalemia, hypocalcemia, hypophosphatemia, metabolic acidosis, azotemia and short stature. A careful and detailed review of his history, repeat physical examinations, laboratory data evaluation, and diagnostic testing solved the mysteries; he had intermittently received multiple doses of parentral Vitamin D(6 lac units) over past several months , but had persistent symptoms. We conclude that he had distal RTA and masked Vitamin D deficiency presenting as weakness, short stature, bone pains and tracheomalacia-causing his stridor.

Keywords:Renal tubular acidosis; Osteomalacia; Growth retardation; Tracheomalacia