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Salt losing nephropathy simulating congenital adrenal hyperplasia in infants with obstructive uropathy and/or vesicoureteral reflux-value of ultrasonography in diagnosis

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Abstract

Salt losing nephropathy, occurring predominantly in male infants, has been reported in association with a spectrum of urologic diseases including obstructive uropathy and massive, infected vesicoureteral reflux (VUR). This has been called pseudo-hypoaldosteronism (PHA) or alternatively, pseudo salt-losing congenital adrenal hyperplasia (CAH), and is thought to reflect a tubular unresponsiveness to aldosterone. We report our experience with six cases, discuss one case in detail and review the 39 cases previously reported. A one month old male infant presented with a left upper quadrant mass. Signs and symptoms included vomiting, dehydration, hyponatremia and hyperkalemia. This suggested the diagnosis of CAH for which therapy was instituted. Ultrasonographic examination subsequently revealed the mass to be a urinoma in an infant with posterior urethral valve (PUV) and obstructive hydronephrosis.

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Author notes

  1. S. J. Abramson

    Present address: Department of Pediatric Radiology, Babies Hospital, 3959 Broadway, 10032, New York, N. Y., USA

Authors and Affiliations

  1. Department of Pediatric Radiology, Babies Hospital, 3959 Broadway, 10032, New York, N. Y., USA

    T. L. Levin, C. Ruzal-Shapiro & W. E. Berdon

  2. Department of Pediatric Urology, Columbia Presbyterian Medical Center, Babies Hospital, New York, USA

    K. A. Burbige

  3. Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, USA

    J. P. Connor

Authors
  1. T. L. Levin
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  2. S. J. Abramson
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  3. K. A. Burbige
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  4. J. P. Connor
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  5. C. Ruzal-Shapiro
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  6. W. E. Berdon
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Levin, T.L., Abramson, S.J., Burbige, K.A. et al. Salt losing nephropathy simulating congenital adrenal hyperplasia in infants with obstructive uropathy and/or vesicoureteral reflux-value of ultrasonography in diagnosis. Pediatr Radiol 21, 413–415 (1991). https://doi.org/10.1007/BF02026675

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  • DOI: https://doi.org/10.1007/BF02026675

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