Book review

https://doi.org/10.20471/acc.2022.61.04.20

Transient Pseudohypoaldosteronism Secondary to Urinary Tract Infection in a Male Infant with Unilateral Hydronephrosis Due to Primary Obstructive Megaureter: A Case Report

Matea Crnković Ćuk ; Department of Pediatrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Ana Kovačević ; Department of Pediatrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Orjena Žaja ; Department of Pediatrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Marija Požgaj Šepec ; Department of Pediatrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Goran Roić ; Department of Radiology, Zagreb Children’s Hospital, Zagreb, Croatia
Bernardica Valent Morić ; Department of Pediatrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Ivana Trutin ; Department of Pediatrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia

Abstract

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 obstructive uropathy at 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. The levels of 17-hydroxyprogesterone, adrenocorticotropic
hormone, cortisol and thyroid-stimulating hormone were normal. Functional magnetic resonance
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 occurrence,
S-PHA can be a potentially life-threatening condition in infants if not recognized and treated appropriately.
Therefore, serum concentrations of electrolytes should be obtained in every child diagnosed
with obstructive anomaly of the urinary tract and/or acute cystopyelonephritis. On the other hand,
every child diagnosed with S-PHA should be evaluated for obstructive anomaly of the urinary tract.

Keywords

Pseudohypoaldosteronism; Unilateral hydronephrosis; Obstructive megaureter

Hrčak ID:

301983

URI

https://hrcak.srce.hr/301983

Publication date:

1.12.2022.

Article data in other languages: croatian

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