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Salt-losing crisis in infants-not always of adrenal origin

Bharathi Pai1, Nick Shaw, Wolfgang Högler

  • 1Department of Endocrinology and Diabetes, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK. bharathipai@hotmail.com

European Journal of Pediatrics
|August 12, 2011
PubMed

Insights

Infants presenting with salt-losing crisis symptoms like hyponatremia and hyperkalemia may have pyelonephritis, not just congenital adrenal disorders. Promptly excluding kidney infection is crucial before considering endocrine causes.

Area of Science:

  • Pediatric Endocrinology
  • Nephrology
  • Genetics

Background:

  • Congenital adrenal hyperplasia is a common cause of salt-losing crisis in infants.
  • Early diagnosis and treatment are vital to prevent mortality.

Observation:

  • Three infants presented with vomiting, hyponatremia, and hyperkalemia, initially suspected as congenital adrenal disorders.
  • Infants showed elevated plasma aldosterone and renin levels.

Findings:

  • The infants' condition was attributed to pyelonephritis and structural kidney anomalies, leading to secondary aldosterone resistance.
  • This highlights that kidney infections can mimic endocrine salt-losing conditions.

Implications:

  • Pyelonephritis should be considered in infants with salt-losing crisis, especially outside the neonatal period.
  • Excluding renal causes is essential before initiating treatment for suspected congenital adrenal disorders.
Abstract

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