A Case of Secondary Pseudohypoaldosteronism Presented With Severe Dehydration and Tachycardia and Hypotension

Background and Aim: Secondary pseudohypoaldosteronism (S-PHA) is a rare condition characterized by resistance to aldosterone, leading to disturbances in electrolyte balance, particularly hyperkalemia and hyponatremia. It can arise from various underlying issues, including renal tubular immaturity and urinary tract anomalies. In this study, we report a case of S-PHA presenting with severe dehydration, tachycardia, and hypotension. Case Presentation: A ۲۷-day-old male infant presented with dehydration, hyponatremia, hyperkalemia, and metabolic acidosis. Investigations revealed elevated aldosterone and cortisol levels, a urinary tract infection (UTI), and severe bilateral vesicoureteral reflux (VUR) with hydronephrosis. He was treated with fluids, electrolytes, antibiotics, and steroids. At ۶ months, he was doing well on steroid replacement and UTI prophylaxis, awaiting surgery for VUR. The case suggests S-PHA, likely secondary to the severe UTI and VUR. Conclusion: In newborns and infants, secondary PHA can result in hyponatremia and hyperkalemia, conditions diagnosed using imaging techniques. The condition is linked to underdeveloped kidneys, urinary tract malformations (UTMs), and infections, but its precise mechanisms and etiology require further investigation.

کلیدواژه ها:

Pseudohypoaldosteronism (PHA) ، Dehydration ، Hypotension