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Case report
Growth failure and metabolic acidosis due to total body sodium depletion in an infant with an ileostomy
  1. Christina Marie Zarraga1 and
  2. Stephen Mark Borowitz2
  1. 1Pediatrics, The University of Arizona College of Medicine Tucson, Tucson, Arizona, USA
  2. 2Pediatrics, University of Virginia, Charlottesville, Virginia, USA
  1. Correspondence to Dr Stephen Mark Borowitz; witz{at}virginia.edu

Abstract

Sodium is an essential nutrient and inadequate sodium intake and/or excessive sodium losses can result in suboptimal growth. Infants with ileostomies are at significant risk of developing growth failure as a result of excessive sodium loss in their ileostomy effluent. Chronic sodium depletion can also limit the kidney’s ability to excrete hydrogen and potassium ions, mimicking electrolyte abnormalities found in type 4 renal tubular acidosis. This report describes an infant with an ileostomy with severe growth failure, hyperkalaemia and metabolic acidosis—all of which promptly resolved with sodium supplementation.

  • nutrition
  • childhood nutrition
  • failure to thrive
  • infant nutrition (including breastfeeding)
  • renal system

https://doi.org/10.1136/bcr-2021-241570

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    Footnotes

    • Contributors CMZ made substantial contributions to the conception or design of this work including acquisition of the clinical data, drafting and revising the manuscript. She gives final approval of the manuscript, and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. SMB made substantial contributions to the conception or design of this work including acquisition of the clinical data, drafting and revising the manuscript. She gives final approval of the manuscript, and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Patient/guardian consent was obtained for publication.

    • Provenance and peer review Not commissioned; externally peer reviewed.