ESPN 51th Annual Meeting

ESPN 2018


 
Attention to transient pseudohypoaldosteronism in infancy with pyelonephritis
MERVE SAPMAZ 1 GÖRKEM ŞAHIN 1 İHSAN TURAN 2 BAHRIYE ATMIS 1 ENGIN MELEK 1 AYSUN KARABAY BAYAZIT 1

1- ÇUKUROVA UNIVERISTY, FACULTY OF MEDICINE, DEPARTMENT OF PEDIATRIC NEPHROLOGY, TURKEY
2- ÇUKUROVA UNIVERISTY, FACULTY OF MEDICINE, DEPARTMENT OF PEDIATRIC ENDOCRINOLOGY, TURKEY
 
Introduction:

 Pseudohypoaldosteronism (PHA) is a group of diseases characterized by mineralocorticoid resistance in target organs and severe salt loss without kidney or adrenal insufficiency. Hyperkalemia, hyponatremia and metabolic acidosis are typical findings of PHA. Type 1 secondary (transient) PHA can often be seen with urinary tract infection and differential diagnosis of the genetic cause of Type 1 PHA should be made.

Material and methods:

A 2.5-month-old girl, who had right multicystic dysplastic kidney and severe left ureterovesical junction (UVJ) obstruction, was hospitalized for pyelonephritis.  

Results:

Double J catheter inserted in newborn period due to severe left UVJ obstruction.  While there was no abnormality in the previous biochemical parameters of the patient, hyponatraemia (sodium: 111 mmol/ L) and hyperkalemia (potassium: 7.4mmol/L) with metabolic acidosis (pH:7.2, bicarbonate: 11 mmol/L) and normal renal functions (creatinine: 0.34 mg/dl) were detected on screening tests at the time of admission. Diagnosis of PHA-1 was confirmed with elevated levels of renin (>500 pg/ml) and aldosterone (>1500 pg/ml). After treatment of pyelonephritis, biochemical parameters were completely normal, renin and aldosterone levels were decreased to normal limits.

 

Conclusions:

 It should be kept in mind that pseudohypoaldosteronism may develop during pyelonephritis in infants and electrolyte and blood gas monitoring should be done.