Pseudohypoaldosteronism Secondary to High Output Ileostomy: A Unique Report in an Infant

Abstract

Salt-losing crisis in an infant should warrant extensive work up. Pseudohypoaldosteronism is a rare condition which is characterized by hyponatremia, hyperkalemia, metabolic acidosis and is associated with high levels of plasma aldosterone. It can be primary or secondary. We report a case of an infant presented with salt-losing crisis and was found to have pseudohypoaldosteronism secondary to excessive losses through ileostomy. This cause of pseudohypoaldosteronism had never been reported previously in children. Additionally, we report an extremely rare association of pseudohypoaldosteronism with thrombocytosis, which can be used as a useful predictor of impending adrenal crisis.

Case Report: Newborns With Pseudohypoaldosteronism Secondary to Excessive Gastrointestinal Losses Through High Output Stoma

“…In some severe cases, PHA may develop (15)(16)(17). Only a few case reports indicated patients with secondary PHA due to excessive gastrointestinal losses through ileostomy, and the condition resolved when the ileostomy was closed (17)(18)(19)(20). In our case series, we examined serum aldosterone level in patients with high output stoma while patient had body weight loss or electrolyte imbalance.…”

Hyponatremia in babies: a 11-year single-center study

“…A survey of the Irish population found that transient PHA occurs at a rate of 1 per 13,200 total live births per year ( 30 ). However, the authors only included the patients who had disorders of the urinary tract ( 31 – 37 ). Intestinal tract disorders can also result in transient PHA, and we reviewed these cases in Supplementary Table S1 .…”