Transient Pseudohypoaldosteronism: A Rare Cause of Severe Hyponatremia in a Baby

Authors

  • F. D’Amico Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
  • A. Li Pomi Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
  • D. Busceti Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
  • G. Zirilli Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
  • G. Salzano Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
  • U. Cucinotta Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
  • C.M. Cassone Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
  • G.F. Vazzana Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
  • M. Valenzise Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy

DOI:

https://doi.org/10.12974/2311-8687.2023.11.08

Keywords:

Pseudohypoaldosteronism, Hyponatremia, Infant

Abstract

Hyponatremia and dehydration in children represent a medical emergency due to a variety of underlying illness. Other than an evidence of gastroenteritis with diarrhea and vomiting (which is the major cause of hypoosmolar hyponatremia in pediatric age), other causes should be considered, especially if there is evidence of hyperkalemia and high sodium fraction excretion (FENa), like iatrogenic causes (diuretic excess), transient or genetic abnormalities of the renal mineralocorticoid pathway, syndrome of inappropriate anti-diuretic hormone secretion (SIADH), acute renal failure, congenital adrenal hyperplasia (CAH).

Here we present a case of transient pseudohypoaldosteronism in a 2 months old baby secondary to urinary tract infection, who presented with a history of poor sucking, fever and dehydration.

References

Latt TN, Rahman SI, Nor NSM. Transient Pseudohypoaldosteronism in an Infant: A Case Report. J ASEAN Fed Endocr Soc. 2018; 33(1): 45-48. https://doi.org/10.15605/jafes.033.01.07 DOI: https://doi.org/10.15605/jafes.033.01.07

Sopfe J, Simmons JH. Failure to thrive, hyponatremia, and hyperkalemia in a neonate. Pediatr Ann. 2013 May; 42(5): 74-9. https://doi.org/10.3928/00904481-20130426-09 DOI: https://doi.org/10.3928/00904481-20130426-09

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

Arai K, Papadopoulou-Marketou N, Chrousos GP. Aldosterone Deficiency and Resistance. 2020 Nov 24. In: Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dhatariya K, Dungan K, Hershman JM, Hofland J, Kalra S, Kaltsas G, Koch C, Kopp P, Korbonits M, Kovacs CS, Kuohung W, Laferrère B, Levy M, McGee EA, McLachlan R, Morley JE, New M, Purnell J, Sahay R, Singer F, Sperling MA, Stratakis CA, Trence DL, Wilson DP, editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000.

Root AW. Disorders of aldosterone synthesis, secretion, and cellular function. Curr Opin Pediatr. 2014 Aug; 26(4): 480-6. https://doi.org/10.1097/MOP.0000000000000104 DOI: https://doi.org/10.1097/MOP.0000000000000104

Storey C, Dauger S, Deschenes G, et al. Hyponatremia in children under 100 days old: incidence and etiologies. Eur J Pediatr 2019; 178(9): 1353-61. https://doi.org/10.1007/s00431-019-03406-8 DOI: https://doi.org/10.1007/s00431-019-03406-8

Zieg J. Pathophysiology of Hyponatremia in Children. Front Pediatr 2017; v.5. https://doi.org/10.3389/fped.2017.00213 DOI: https://doi.org/10.3389/fped.2017.00213

Maghnie M, Loche S, Cappa M, Ghizzoni L, Lorini R (eds): Hormone Resistance and Hypersensitivity. From Genetics to Clinical Management. Endocr Dev. Basel, Karger, 2013, vol 24, pp 86-95. https://doi.org/10.1159/isbn.978-3-318-02268-1 DOI: https://doi.org/10.1159/isbn.978-3-318-02268-1

Delforge X, Kongolo G, Cauliez A,et al. Transient pseudohypoaldosteronism: a potentially severe condition affecting infants with urinary tract malformation. Journal of Pediatric Urology 2019; 15: 265.e1-265.e7. https://doi.org/10.1016/j.jpurol.2019.03.002 DOI: https://doi.org/10.1016/j.jpurol.2019.03.002

Sethi SK, Wazir S, Bansal S, Khokhar S, Wadhwani N, Raina R. Secondary Pseudohypoaldosteronism Masquerading Congenital Adrenal Hyperplasia in a Neonate. Kidney Int Rep. 2018 Jan 31; 3(3): 752-754. https://doi.org/10.1016/j.ekir.2018.01.004 DOI: https://doi.org/10.1016/j.ekir.2018.01.004

Manikam L, Cornes MP, Kalra D, et al. Transient pseudohypoaldosteronism masquerading as congenital adrenal hyperplasia. Ann Clin Biochem 2011; 48(Pt 4): 380-2. https://doi.org/10.1258/acb.2011.010264 DOI: https://doi.org/10.1258/acb.2011.010264

Graziano N, Agostoni C, Chiaraviglio F et al. Milani GP. Pseudo-hypoaldosteronism secondary to infantile urinary tract infections: role of ultrasound. Ital J Pediatr. 2022 Jan 24; 48(1): 14. https://doi.org/10.1186/s13052-022-01203-y DOI: https://doi.org/10.1186/s13052-022-01203-y

Abraham MB, Larkins N, Choong CS, et al. Transient pseudohypoaldosteronism in infancy secondary to urinary tract infection. J Pediatr Child Health 2017; 53(5): 458-63. https://doi.org/10.1111/jpc.13481 DOI: https://doi.org/10.1111/jpc.13481

De Clerck M, Vande Walle J, Dhont E, et al. An infant presenting with failure to thrive and hyperkalaemia owing to transient pseudohypoaldosteronism: case report. Paediatr Int Child Health 2018; 38(4): 277-80. https://doi.org/10.1080/20469047.2017.1329889 DOI: https://doi.org/10.1080/20469047.2017.1329889

Nandagopal R, Vaidyanathan P, Kaplowitz P. Transient Pseudohypoaldosteronism due to Urinary Tract Infection in Infancy: A Report of 4 Cases. Int J Pediatr Endocrinol 2009; 2009: 195728. https://doi.org/10.1186/1687-9856-2009-195728 DOI: https://doi.org/10.1186/1687-9856-2009-195728

Pai B, Shaw N, Hogler W. Salt-losing crisis in infants-not always of adrenal origin. Eur. J. Pediatr 2012; 171: 317-21. https://doi.org/10.1007/s00431-011-1541-3 DOI: https://doi.org/10.1007/s00431-011-1541-3

Bertini, A., Milani, G.P., Simonetti, G.D. et al. Na+, K+, Cl−, acid-base or H2O homeostasis in children with urinary tract infections: a narrative review. Pediatr Nephrol 31, 1403-1409 (2016). https://doi.org/10.1007/s00467-015-3273-5 DOI: https://doi.org/10.1007/s00467-015-3273-5

Memoli E, Lava SAG, Bianchetti MG, et al. Prevalence, diagnosis, and management of secondary pseudohypoaldosteronism. Pediatr Nephrol. 2020 Apr; 35(4): 713-714. https://doi.org/10.1007/s00467-019-04419-z

Tuoheti Y, Zheng Y, Lu Y, Li M, Jin Y. Transient pseudohypoaldosteronism in infancy mainly manifested as poor appetite and vomiting: Two case reports and review of the literature. Front Pediatr. 2022 Aug 25; 10: 895647. https://doi.org/10.3389/fped.2022.895647 DOI: https://doi.org/10.3389/fped.2022.895647

Memoli E, Lava SAG, Bianchetti MG, Vianello F, Agostoni C, Milani GP. Prevalence, diagnosis, and management of secondary pseudohypoaldosteronism. Pediatr Nephrol. 2020 Apr; 35(4): 713-714. https://doi.org/10.1007/s00467-019-04419-z DOI: https://doi.org/10.1007/s00467-019-04419-z

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Published

2023-06-22

How to Cite

D’Amico, F. ., Pomi, A. L. ., Busceti, D. ., Zirilli, G. ., Salzano, G. ., Cucinotta, U. ., Cassone, C. ., Vazzana, G. ., & Valenzise, M. . (2023). Transient Pseudohypoaldosteronism: A Rare Cause of Severe Hyponatremia in a Baby. International Journal of Pediatrics and Child Health, 11, 50–53. https://doi.org/10.12974/2311-8687.2023.11.08

Issue

Vol. 11 (2023)

Section

Articles