Naslov
Transient pseudohypoaldosteronism secondary to urinary tract infection in a male infant with unilateral hydronephrosis and obstructive uropathy: case report

Autori
Crnković Ćuk, Matea ; Kovačević, Ana ; Žaja, Orjena ; Požgaj Šepec, Marija ; Roić, Goran ; Valent Morić, Bernardica ; Trutin, Ivana

Izvornik
Acta clinica Croatica (0353-9466) 61 (2022), 4; 717-721

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
transient pseudohypoaldosteronism ; electrolyte abnormalities ; obstructive anomalies of urinary tract

Sažetak
We present a case of transient form of type 1 pseudohypoaldosteronism (S-PHA) in a 1, 5-month- old male infant who presented with lethargy, failure to thrive, severe hyponatremia (Na=118 mmol/L), hypochloremia (Cl=93 mmol/L) and fever due to urinary tract infection. Potassium levels were normal. Markedly elevated serum aldosterone level and elevated serum renin confirmed the diagnosis of pseudohypoaldosteronism. Renal ultrasound showed grade III hydronephrosis on the left kidney while contrast-enhanced voiding urosonography excluded the existence of vesicoureteral reflux which raised suspicion of opstructive uropathy on the level of vesicoureteral junction. Serum sodium normalized after several days of intravenous fluids and antibiotic therapy after which oral supplementation of sodium was introduced. Levels of 17-hydroxyprogesterone, ACTH, cortisole and TSH were normal. Functional MR urography conducted at the age of 3 months confirmed the diagnosis of primary congenital obstructive megaureter and the infant was referred to a pediatric surgeon. Although a rare occurence, S-PHA can be a potentially life threatening condition in infants if not recognized and treated adequately. Therefore, serum concentrations of electrolytes should be obtained in every child with diagnosed obstructive anomaly of the urinary tract and/or acute cystopyelonephritis. On the other hand, every child with diagnosed S-PHA should be evaluated for obstructive anomaly of the urinary tract.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA