Salty Mystery and Silent Storm: Neonatal Shock Revealing Pseudohypoaldosteronism: A Case Study
Keywords:
Pseudohypoaldosteronism, Aldosterone Resistance, Neonate, Hyperkalemia, Hyponatremia, Salt-Wasting.Abstract
Pseudohypoaldosteronism (PHA) is a rare but serious condition in neonates, often mimicking congenital adrenal hyperplasia (CAH). We present a case of a 16-day-old female neonate with a 10-day history of persistent vomiting, poor feeding, lethargy, and severe dehydration. Laboratory findings revealed hyponatremia, hyperkalemia, and metabolic acidosis. Initial suspicion of CAH prompted steroid therapy, but hormone profiles showed normal cortisol, Adrenocorticotropic hormone (ACTH), and 17-hydroxyprogesterone levels with markedly elevated renin and aldosterone levels, confirming PHA. The infant responded to fluid resuscitation, sodium supplementation, and potassium-binding therapy. This case highlights the importance of early differentiation between CAH and PHA to guide appropriate management and avoid unnecessary corticosteroid therapy.
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