Parisi G, Rojo S, De Pascale S, Mancinelli C, D'Alonzo L, Galante E, Marinelli L, Damiani F
Unità Operativa Pediatrico Neonatologica, Presidio Ospedaliero di Vasto, Azienda USL Lanciano-Vasto, Chieti, Italia.
Pediatr Med Chir. 1998 Jul-Aug;20(4):289-93.
A case of secondary transient pseudohypoaldosteronism (PHA) in a three-month-old infant who had arrived in emergency conditions is reported. Clinically the patient presented dehydration associated with salt loss, metabolic acidosis, severe hyperkalemia, markedly elevated levels both of plasma renin activity and aldosterone concentration. Biochemical and instrumental tests and clinical evolution have given reason to consider it as a case of transient PHA, secondary to an obstructive uropathy (PUV) with urinary infection. Secondary forms of PHA have frequently been documented in young infants with urinary tract infection associated with both obstructive and non obstructive uropathy. After medical or surgical therapy the abnormalities quickly disappear. This reported case suggests that the pediatrician-neonatologist dealing with a young infant with obstructive uropathy should not only consider the surgical treatment but also the medical one, in the light of the associated physiopathological aspects.
报告了一例三个月大婴儿出现继发性短暂性假性醛固酮减少症（PHA）的病例，该婴儿以紧急情况入院。临床上，患者表现出与失盐相关的脱水、代谢性酸中毒、严重高钾血症，血浆肾素活性和醛固酮浓度均显著升高。生化和仪器检查以及临床进展表明，该病例可被视为继发于梗阻性尿路病（后尿道瓣膜症）合并泌尿系统感染的短暂性PHA。PHA的继发性形式在患有与梗阻性和非梗阻性尿路病相关的泌尿系统感染的幼儿中经常有记录。经过药物或手术治疗后，异常情况迅速消失。该报告病例表明，处理患有梗阻性尿路病的幼儿的儿科医生和新生儿科医生，鉴于相关的生理病理方面，不仅应考虑手术治疗，还应考虑药物治疗。
