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Pediatric Radiology

, Volume 21, Issue 6, pp 413–415 | Cite as

Salt losing nephropathy simulating congenital adrenal hyperplasia in infants with obstructive uropathy and/or vesicoureteral reflux-value of ultrasonography in diagnosis

  • T. L. Levin
  • S. J. Abramson
  • K. A. Burbige
  • J. P. Connor
  • C. Ruzal-Shapiro
  • W. E. Berdon
Originals

Abstract

Salt losing nephropathy, occurring predominantly in male infants, has been reported in association with a spectrum of urologic diseases including obstructive uropathy and massive, infected vesicoureteral reflux (VUR). This has been called pseudo-hypoaldosteronism (PHA) or alternatively, pseudo salt-losing congenital adrenal hyperplasia (CAH), and is thought to reflect a tubular unresponsiveness to aldosterone. We report our experience with six cases, discuss one case in detail and review the 39 cases previously reported. A one month old male infant presented with a left upper quadrant mass. Signs and symptoms included vomiting, dehydration, hyponatremia and hyperkalemia. This suggested the diagnosis of CAH for which therapy was instituted. Ultrasonographic examination subsequently revealed the mass to be a urinoma in an infant with posterior urethral valve (PUV) and obstructive hydronephrosis.

Keywords

Public Health Dehydration Aldosterone Hydronephrosis Congenital Adrenal Hyperplasia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Cheek DB, Perry JW (1958) A salt wasting syndrome in infancy. Arch Dis Child 33:252PubMedGoogle Scholar
  2. 2.
    Proesmans W, Muaka KB, Corbeel L, Eckels R (1978) Pseudohypoaldosteronism, a proximal tubular sodium wasting disease. J Pediatrics 92:678Google Scholar
  3. 3.
    Soriano JR, Vallo A, Oliveros R, Gonzalo C (1983) Transient pseudo-hypoaldosteronism secondary to obstructive uropathy in infancy. J Pediatr 102:375Google Scholar
  4. 4.
    Heijden AJ, Versteegh FGA, Wolff EO, Sukhai RN, Scholtmeijer RJ (1985) Acute tubular dysfunction in infants with obstructive uropathy. Acta Paediatr Scand 74:589PubMedGoogle Scholar
  5. 5.
    Marra G, Goj V, Appiani AC, Dell Angola CA, Tirelli SA, Tadini B, Assael BM (1987) Persistent tubular resistance to aldosterone in infants with congenital hydronephrosis corrected neonatally. J Pediatr 110:868PubMedGoogle Scholar
  6. 6.
    Vaid YN, Lebowitz RL (1989) Urosepsis in infants with vesicoureteral reflux masquerading as the salt losing type of congenital adrenal hyperplasia. Pediatr Radiol 19:548PubMedGoogle Scholar
  7. 7.
    Sivit CJ, Hung W, Taylor GA, Catena LM, Brown-Jones C, Kushner D (1991) Sonography in neonatal congenital adrenal hyperplasia. AJR 156:141PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • T. L. Levin
    • 1
  • S. J. Abramson
    • 1
  • K. A. Burbige
    • 2
  • J. P. Connor
    • 3
  • C. Ruzal-Shapiro
    • 1
  • W. E. Berdon
    • 1
  1. 1.Department of Pediatric RadiologyBabies HospitalNew YorkUSA
  2. 2.Department of Pediatric UrologyColumbia Presbyterian Medical Center, Babies HospitalNew YorkUSA
  3. 3.Department of UrologyMemorial Sloan-Kettering Cancer CenterNew YorkUSA

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