Acute dehydration with vomiting can reveal salt-losing syndrome. Report ofa case of pseudohyperaldosteronism

Sodium level abnormalities can occur as a result of vomiting with acute deh ydration, a setting in which they can complicate the diagnosis of pseudo-hy peraldosteronism. A 14-month-old boy was admitted for the second time with acute dehydration with vomiting and Low serum sodium (120 mmol/L). Salt-los ing syndrome due to an endocrine disorder was suspected because of the recu rrent and persistent hyponatremia with a relatively high urinary sodium:lev el (11 mmol/L). Basal serum aldosterone was 3330 pg/L and serum renin activ ity was 225 pg/ml, establishing a diagnosis of pseudo-hyperaldosteronism. D aily sodium supplementation was started. At last follow-up 14 months later, the patient was doing well and had normal serum sodium, aldosterone and re nin activity levels.