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A 2-month-old healthy thriving term male infant presented with hypocalcaemic generalised tonic–clonic seizures associated with renal failure (plasma creatinine level 198 μmol/l), severe metabolic acidosis (pH 6.94) and pancytopenia. Renal ultrasound showed bilateral echogenic kidneys, unlike classical nephrocalcinosis with mild prominence of the pelvicalyceal systems (fig 1).
Competing interests: None declared.
We would like to acknowledge Mr Rajnish Sekhri and Mr Ken Nischal for their assistance and for providing figure 3.