5950 Pseudo-hypoaldosteronism secondary to a urinary tract infection in a neonate

Objectives To alert the paediatric community of this unusual presentation of electrolyte abnormalities, the most differentials, and management steps. Methods Prospective and retrospective data collection during the admission of this patient to the neonatal unit. Results Secondary pseudohypoaldosteronism is a condition characterized by aldosterone resistance in renal tubules. It is highly associated in the literature with urinary tract infections and malformations, especially in male infants. A three day old term male infant was admitted in the neonatal unit with jaundice. Apart from hyper- bilirubinaemia, his laboratory test results revealed hyponatremia and hyperkalaemia, and pyuria. He was treated with intravenous fluids, calcium gluconate, enteral feeding, and antimicrobial therapy. Electrolyte disorders were addressed and he was discharged on the 7th day of hospitalization without any sequelae. His urine culture showed mixed growth and his renal ultrasonography showed no abnormalities. Conclusion Transient pseudohypoaldosteronism is an important consideration in the differential diagnosis in infants with hyponatremia and hyperkalaemia, even when investigations show no abnormality. It should be considered in cases presenting for a different primary reason and where such electrolyte imbalances are an incidental finding. References Fountain JH, Kaur J, Lappin SL. Physiology, Renin Angiotensin System. [Updated 2023 Mar 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470410/. Watanabe T. Reversible secondary pseudohypoaldosteronism. Pediatr Nephrol 2003;18:486. https://doi.org/10.1007/s00467-003-1104-6. Llana I, Sanchez-Redondo M, Benedit M, et al. 960 Secondary Pseudohypoaldosteronism Due to Pyelonephritis: Two Cases Report. Archives of Disease in Childhood 2012;97:A274. Rodríguez-Soriano J, Vallo A, Oliveros R, Castillo G. Transient pseudohypoaldosteronism secondary to obstructive uropathy in infancy. J Pediatr. 1983;103:375–80. 10.1016/s0022–3476(83)80406–5. Delforge X, Kongolo G, Cauliez A, Braun K, Haraux E, Buisson P. Transient pseudohypoaldosteronism: a potentially severe condition affecting infants with urinary tract malformation. J Pediatr Urol. 2019;15:265.e1–7. 10.1016/j.jpurol.2019.03.002.