Salt-losing crisis in infants—not always of adrenal origin
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Bharathi Pai & Nick Shaw &Wolfgang Hِgler
- چاپ و سال / کشور: 2011
Description
Three infants (age 1.5, 4 and 7 months) presented with vomiting, hyponatremia and hyperkalaemia suggestive of a salt-losing congenital adrenal condition. Diagnostic endocrine bloods were taken and adrenal steroid therapy was started. The infants were subsequently found to have raised plasma aldosterone and renin levels due to pyelonephritis and structural anomalies of the kidneys, demonstrating secondary aldosterone resistance. Conclusion Establishing the diagnosis of congenital adrenal disorders is essential in a baby who develops a salt-losing crisis in the first few weeks of life. However, pyelonephritis should be considered and can be rapidly excluded in any infant presenting with a saltlosing crisis with hyponatremia and hyperkalaemia, in particular, outside the neonatal period. Only then should an endocrine cause for this presentation be considered and treatment commenced.
Eur J Pediatr DOI 10.1007/s00431-011-1541-3 Received: 2 May 2011 / Accepted: 23 July 2011
