Distal renal tubular acidosis with rhabdomyolisis in pregnant women

We describe four pregnant patients with distal renal tubular acidosis (type I) (DRTA) whose initial presentation was rhabdomyolysis (RML) secondary to severe hypokalemia. We draw attention to the unusual presentation of DRTA during pregnancy, the low frequency of DRTA in adult patients and RML as in itial manifestation. In one case the DRTA was secondary to Sjogren Syndrome and the etiology was unknown in the rest of the cases. We discuss the pote ntial pathogenic mechanisms to explain hypokalemic RML and the various caus es of DRTA in adult patients.