David Ban, MD, Junior Assistant Resident in Medicine, the Jewish Hospital of St Louis: A 70-year-old woman was seen at our hospital in December 1980, complaining of a weight loss of 23 kg during a one-year period. Her medical history was notable for multiple hospital admissions caused by pneumonia and for hypertension that she had had for 15 years. She denied having had diabetes mellitus or renal disease, and her family history did not disclose either of these conditions. She had smoked cigarettes until one year before this hospital admission.
A physical examination disclosed a thin, elderly woman who appeared older than her stated age. Her vital signs were normal. She was found to have had an enlarged thyroid gland, with a palpable nodule in the left lobe. There was evidence of muscle atrophy. Findings from the rest of the physical examination were normal.
Laboratory studies disclosed the following values:
Hruska KA, Ban D, Avioli LV. Renal Tubular Acidosis. Arch Intern Med. 1982;142(10):1909–1913. doi:10.1001/archinte.1982.00340230157025