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Renal Tubular Acidosis Associated With Zonisamide Therapy

PURPOSE
We sought to report a previously undescribed adverse effect, renal tubular acidosis associated with zonisamide (ZNS) therapy.


METHODS
Ammonium chloride, bicarbonate, and furosemide loading tests were performed in an epileptic patient with metabolic acidosis and episodic hypokalemia who was treated with ZNS.


RESULTS
Distal renal tubular acidosis was diagnosed. On reexamination 7 weeks after ZNS had been replaced with phenytoin, the renal tubular acidosis disappeared.


CONCLUSIONS
This case indicates, for the first time, that ZNS might be a potential cause of renal tubular acidosis. Blood gases and serum electrolytes should be measured in patients undergoing ZNS therapy.