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The incidence of transient infantile pseudohypoaldosteronism in Ireland: A prospective study.

Authors
  • Kaninde, Abhidhamma1
  • Grace, Mariana L2
  • Joyce, Caroline3
  • Taylor, Norman F4
  • Ghataore, Lea5
  • Riordan, Micheal F6
  • O'Grady, Michael J7
  • O'Connell, Susan M6
  • 1 Leicester Royal Infirmary, Leicester, UK.
  • 2 Department of Paediatrics and Child Health, Cork University Hospital, Cork, Ireland. , (Ireland)
  • 3 Department of Clinical Biochemistry, Cork University Hospital, Cork, Ireland. , (Ireland)
  • 4 Department of Clinical Biochemistry, King's College London, London, UK.
  • 5 Principal Clinical Scientist, Department of Biochemistry, King's College London, London, UK.
  • 6 Department of Paediatric Endocrinologist, Children's Health Ireland at Crumlin, Dublin, Ireland. , (Ireland)
  • 7 Department of Paediatrics, Regional Hospital Mullingar, Co Westmeath, Ireland. , (Ireland)
Type
Published Article
Journal
Acta Paediatrica
Publisher
Wiley (Blackwell Publishing)
Publication Date
Apr 01, 2021
Volume
110
Issue
4
Pages
1257–1263
Identifiers
DOI: 10.1111/apa.15688
PMID: 33245792
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To review the clinical course, outcome and incidence of infantile salt wasting associated with urinary tract infection (UTI) and/or urinary tract malformation (UTM) over a two-year surveillance period on the island of Ireland. A two-year (2013-14) prospective surveillance undertaken via the Irish and Ulster Paediatric Surveillance Units. Monthly prepaid postcards were circulated to consultant paediatricians (n = 260) at all paediatric units on the island of Ireland. Infants under one year of age presenting for the first time with hyponatraemia (Na < 130 mmol/L) and/or hyperkalaemia (K > 5.0 mmol/L) associated with urosepsis/UTM were reported. All 7 reported patients (6 male) had culture-proven UTI, and 5 (71%) also had an underlying UTM (one diagnosed antenatally). Four (57%) patients had a documented elevated serum aldosterone supporting secondary pseudohypoaldosteronism (PHA) as the underlying diagnosis. Data on aldosterone were not reported in the other 3 patients, but clinical features were suggestive of secondary PHA. The estimated incidence for the Irish population of transient PHA is 1 per 13,200 total live births per year. Salt wasting is a rare complication of UTI, especially if associated with underlying UTM. Boys appear to be at particular risk. ©2020 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

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