Abstract.
A pair of non-identical twins with severe pseudohypoaldosteronism (PHA) were followed over a period of 4 years. The diagnosis was based on dehydration, hyponatremia, hyperkalemia, high urine sodium/potassium ratios, and high serum concentrations of aldosterone and renin. Sweat and saliva electrolyte concentrations were high, suggesting multifocal target-organ unresponsiveness to mineralocorticoids. No hydramnios was observed during pregnancy. Despite continuous treatment with sodium chloride and sodium bicarbonate (≤20 g/day) and cation exchange resin (Kayexalate, sodium polystyrene sulfonate, ≤4 g/kg per day), the children had repeated episodes of dehydration, hyponatremia, and hyperkalemia. Growth velocity was normal in both twins. Catch-up growth was observed following infancy in the first twin. Normalization of plasma aldosterone, electrolytes, and renin concentrations was achieved at the age of 9 months.
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Received December 13, 1994; received in revised form September 15, 1995; accepted October 6, 1995
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Bistritzer, T., Lahat, E., Eshel, G. et al. Severe pseudohypoaldosteronism in a pair of twins not associated with hydramnios. Pediatr Nephrol 10, 438–441 (1996). https://doi.org/10.1007/s004670050134
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DOI: https://doi.org/10.1007/s004670050134