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Pseudo-hypo aldosteronism Type II.

N Prahlad1, M Vijayakumar, B R Nammalwar

  • 1Department of Pediatric Nephrology, Kanchi Kamakoti Childs Trust Hopital, Chennai 600 034, India.

Indian Pediatrics
|July 5, 2005
PubMed
Summary
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This study details a rare case of Type II pseudo-hypoaldosteronism in an infant with meningitis. Treatment with oral thiazide successfully normalized electrolyte levels, resolving the condition.

Area of Science:

  • Pediatric Endocrinology
  • Nephrology
  • Infectious Diseases

Background:

  • Pseudo-hypoaldosteronism (PHA) is a rare disorder characterized by aldosterone resistance.
  • Type II PHA, also known as apparent mineralocorticoid excess, presents with hypertension and hypokalemic alkalosis, but this case presents a variant.
  • Infants with meningitis can develop complex electrolyte disturbances.

Observation:

  • A 50-day-old infant with meningitis presented with persistent hyperkalemia, metabolic acidosis, and normal serum sodium.
  • Further investigations revealed low transtubular potassium gradient (TTKG), low serum renin, and low-normal serum aldosterone.
  • No evidence of renal failure or other extra-renal causes for hyperkalemia was found.

Findings:

  • The clinical presentation and laboratory findings were consistent with a diagnosis of Type II pseudo-hypoaldosteronism.

Related Experiment Videos

  • The infant was treated with oral thiazide diuretics.
  • Serum electrolytes normalized following thiazide administration.

    • Implications:

    • This case highlights a rare presentation of Type II pseudo-hypoaldosteronism in an infant.
    • It underscores the importance of considering endocrine disorders in infants with unexplained electrolyte abnormalities, even with concurrent infections.
    • Thiazide diuretics can be an effective treatment for this specific subtype of pseudo-hypoaldosteronism.