PSEUDOHYPOALDOSTERONISM - REPORT OF A CASE PRESENTING AS FAILURE-TO-THRIVE

We report a 2 month-old infant referred for failure to thrive, At birt h, weight was 3820 g and length 52 cm. After physiologic weight loss, the patient showed no further weight gain for the next two months, On admittance (age 2 mo), weight was 3340 g and length 53 cm; the infant had severe dystrophy, generalized hypotonia and dehydration; blood che mistry showed hyponatremia, hyperkalemia and hypochloremia. A salt los ing syndrome of adrenal origin was hypothesized, However, rehydration and hydrocortisone administration failed to correct hyponatremia and h yperkalemia, Endocrine assessment showed high levels of aldosterone an d plasma renin activity, suggesting pseudohypoaldosteronism. Oral sodi um chloride supplementation normalized electrolyte balance and the pat ient showed progressive weight gain and catch-up growth, confirming th e diagnosis.