TRANSIENT PSEUDOHYPOALDOSTERONISM TYPE 1 ASSOCIATED WITH URINARY TRACT INFECTION AND POSTERIOR URETHRAL VALVE: CASE REPORT

Abstract

Persistent, severe neonatal hyponatremia coexisting with hyperkalemia and metabolic acidosis though not a very common yet is a fatal condition. Among the differential diagnosis of gastrointestinal fluid loss, salt loosing congenital adrenal hyperplasia and type IV renal tubular acidosis, Pseudohypoaldosteronism Type 1 (PHA 1) should also be kept in mind. Here we report a case of 2 months old baby boy with poor feeding, failure to thrive and persistent vomiting. His biochemical profile revealed severe hyponatremia, hyperkalemia, metabolic acidosis and raised Plasma Aldosterone and Plasma Active Renin Mass Concentration (ARC). Child had severe multi drug resistant urinary tract infection by Klebsiella oxytoca complicating obstructive uropathy caused by posterior urethral valve. Subsequently the PHA 1 subsided once the child was treated successfully for urinary tract infection and posterior urethral valve was removed surgically. Thus, highlighting association of urinary tract infection and posterior urethral valve with development of transient PHA type-1.

Key Words: Neonatal hyponatremia, Urinary tract infection, Transient pseudohypoaldosteronism type 1.