Renal biopsies and sera of four patients with distal renal tubular acidosis were examined. The findings consisted of immunoglobulin containing mononuclear cellular infiltrates around the distal tubules, bound immunoglobulin and complement in tubules. The sera of the patients contained antibodies reacting with various tissue antigens, among them renal tubular antigens. The results suggest that autoimmunity was involved in the pathogenesis of the renal tubular acidosis in these patients.
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