Analysis of patients presenting with serum electrolyte imbalance in terms of the differential diagnosis of pseudohypoaldosteronism
Northern Clinics of Istanbul, cilt.10, sa.6, ss.754-760, 2023 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 10 Sayı: 6
- Basım Tarihi: 2023
- Doi Numarası: 10.14744/nci.2022.70105
- Dergi Adı: Northern Clinics of Istanbul
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Central & Eastern European Academic Source (CEEAS), Directory of Open Access Journals, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.754-760
- Anahtar Kelimeler: Hyperkalemia, hyponatremia, pseudohypoaldosteronism, urinary tract infection, urinary tract malformation.
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
OBJECTIVE: The aim of this study was to contribute to the differential diagnosis of transient pseudohypoaldosteronism (t-PHA). METHODS: Twenty-nine infants, younger than 24 weeks, and with high aldosterone levels were included in the study. The patients were divided into two groups as t-PHA and other diagnoses group. Of 29 patients, 18 were in the t-PHA group and 11 were in other diagnoses group. RESULTS: The means aldosterone, plasma renin activities (PRA), adrenocorticotropic hormone (ACTH), cortisol, and 17-hydroxyprogesterone (17-OHP) of those with t-PHA were 138±92.8 ng/dL, 8.39±10.57 ng/mL/h, 26.86±19.56 ng/L, 19.44±21.84 μg/dL, and 7.66±10.71 ng/mL, respectively. In other diagnoses group, the mean level of aldosterone, PRA, ACTH, cortisol, and 17-OHP levels was 100.9±70 ng/dL, 5.49±8.41 ng/mL/h, 408.28±491.9 ng/L, 19.99±14.43 μg/dL, and 11.99±12.21 ng/mL, respectively. In the t-PHA group, the number of patients with high PRA was eight (50%), while the number of patients with high levels was two (18.1%) in other diagnoses group. In the t-PHA group, although the average serum K levels were the same in both groups, serum aldosterone/K ratios were higher. CONCLUSION: When an infant younger than 24 weeks, with urinary tract infection and/or urinary tract malformation has electrolyte abnormalities, pediatricians should primarily consider the diagnosis of t-PHA. Thus, many unnecessary investigations and inappropriate treatments can be avoided.