Oral Manifestations in a Child With Distal Renal Tubular Acidosis, and Refractory Rickets.

Renal tubular acidosis (RTA) is a group of disorders in which there is an alteration in acid-base homeostasis because of the impairment of nephrons to excrete hydrogen ions or reabsorb bicarbonate ions, resulting in chronic metabolic acidosis. RTA is an important cause of rickets, particularly 'resistant rickets'. Dental manifestations frequently reported in patients with RTA include enamel hypoplasia and amelogenesis imperfecta, affecting permanent dentition. To the best of our knowledge, the literature pertaining to the dental manifestations in RTA with secondary rickets is scarce. This case highlights oral manifestations in a 6-year-old girl with RTA, distal, four with haemolytic anaemia a rare form diagnosed on genetic testing, and refractory rickets having multiple missing teeth and enamel hypo-mineralisation. The radiograph revealed alveolar bone loss in both jaws with widened pulp chambers and root canals in primary teeth. Pre-eruptive enamel breakdown in multiple unerupted permanent teeth was also evident radiographically.