Distal Renal Tubular Acidosis Associated with Celiac Disease and Thyroiditis.

Background: Association of distal renal tubular acidosis (RTA) with autoimmune diseases is extremely rare in children.Case Characteristics: 12-year-old girl with distal RTA. Despite resolution of acidosis on bicarbonate, she continued to have poor growth and delayed puberty. Investigations revealed autoimmune thyroiditis and celiac disease. Outcome: Levothyroxine and gluten-free diet were initiated. Child gained height and weight and had onset of puberty after gluten withdrawal. Messages: Distal RTA in children may rarely be of autoimmune etiology.