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Case report
Rare case of pseudohypoaldosteronism in a neonate secondary to congenital hydrometrocolpos
  1. Shruti Kumar1,
  2. Helen McDermott1,
  3. Sheilah Kamupira2 and
  4. Juliana Chizo Agwu2
  1. 1Health Education England West Midlands, Edgbaston, UK
  2. 2Department of Paediatrics and Neonatology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
  1. Correspondence to Dr Helen McDermott; helen.mcdermott{at}nhs.net

Abstract

Pseudohypoaldosteronism (PHA) due to obstructive uropathy, urinary tract infections and congenital urogenital malformations has been reported in the literature; however, there are no reports of PHA associated with hydrometrocolpos due to a common urogenital tract. Hydrometrocolpos is a condition resulting in distension of the vagina and uterus due to accumulation of secretions (other than blood), caused by increased oestrogenic stimulation and vaginal outflow obstruction. We report on a neonatal case of PHA caused by recurrent hydrometrocolpos presenting with vomiting and poor weight gain. There was significant hyponatraemia, hyperkalaemia, and anaemia requiring medical stabilisation prior to surgery. The mechanism by which PHA occurs in obstruction involves renal tubular dysfunction due to pressure from hydronephrosis and the release of intrarenal cytokines. In addition, there is an immature or resistant renal tubular responsiveness to aldosterone during infancy. Clinicians should be aware of this uncommon but serious presentation.

  • adrenal disorders
  • neonatal intensive care
  • neonatal health
  • fluid electrolyte and acid-base disturbances
  • urology
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Footnotes

  • Contributors The manuscript was written by SKu and HM, reviewed and contributed to by JCA and SKa. Patient consent was taken by SKu.

  • 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 Parental/guardian consent obtained.

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

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