Transient Pseudohypoaldosteronism in an Infant: A Case Report

Tin Nwe Latt, Siti Iryawani Rahman, Noor Shafina Mohd Nor

Abstract

Transient pseudohypoaldosteronism is strongly linked to urinary tract infections complicating structural urinary tract anomalies. A 3-month-old baby girl with hyponatremia, hyperkalemia and metabolic acidosis associated with urinary tract infection and structural urinary tract anomalies was diagnosed with transient pseudohypoaldosteronism following elevated serum aldosterone and normal 17-hydroxyprogesterone level. Electrolytes normalized with corrections and antibiotic therapy. Clinicians should have a high index of suspicion of transient pseudohypoaldosteronism in an infant presenting with hyponatremia, hyperkalemia and urinary tract infection with or without associated urinary tract anomalies.

Keywords

pseudohypoaldosteronism, urinary tract infection (UTI), urinary tract anomalies

Full Text:

Abstract

References

Cheong HI. Pseudohypoaldosteronism Type 1. J Genet Med. 2013;10(2):81-7. https://doi.org/10.5734/JGM.2013.10.2.81.

Geller DS. Mineralocorticoid resistance. Clin Endocrinol (Oxf). 2005;62(5):513-20. PMID: 15853818. https://doi.org/10.1111/j.1365-2265.2005.02229.x.

Hanukoglu A. Type I pseudohypoaldosteronism includes two clinically and genetically distinct entities with either renal or multiple target organ defects. J Clin Endocrinol Metab. 1991;73(5):936-44. PMID: 1939532. https://doi.org/10.1210/jcem-73-5-936.

Cheek DB, Perry JW. A salt wasting syndrome in infancy. Arch Dis Child. 1958; 33(169):252-6. PMID: 13545877. PMCID: PMC2012226.

Lee SE, Jung YH, Han KH, et al. A case of pseudohypoaldosteronism type 1 with a mutation in the mineralocorticoid receptor gene. Korean J Pediatr. 2011;54(2):90-3. PMID: 21503203. PMCID: PMC3077507. https://doi.org/10.3345/kjp.2011.54.2.90.

Rodríguez-Soriano J, Vallo A, Oliveros R, Castillo G. Transient pseudohypoaldosteronism secondary to obstructive uropathy in infancy. J Pediatr. 1983; 103(3):375–80. PMID: 6350553.

Watanabe T. Reversible secondary pseudohypoaldosteronism. Pediatr Nephrol. 2003; 18(5):486. PMID: 12736813. https://doi.org/10.1007/s00467-003-1104-6.

Melzi ML, Guez S, Sersale G, et al. Acute pyelonephritis as a cause of hyponatremia/hyperkalemia in young infants with urinary tract malformations. Pediatr Infect Dis J. 1995;14(1):56–9. PMID:7715992.

Krishnappa V, Ross JH, Kenagy DN, Raina R. Secondary or transient pseudohypoaldosteronism associated with urinary tract anomaly and urinary infection: a case report. Urol Case Rep. 2016;8:61-2. PMID: 27516976. PMCID: PMC4976642. https://doi.org/10.1016/j.eucr.2016.07.001.

Schoen EJ, Bhatia S, Ray GT, Clapp W, To TT. Transient pseudohypoaldosteronism with hyponatremia-hyperkalemia in infant urinary tract infection. J Urol. 2002;167(2 Pt 1): 680–2. PMID: 11792953.