Childhood Kidney Diseases

Korean Society of Pediatric Nephrology (대한소아신장학회)
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Transient Pseudohypoaldosteronism in an Infant with Vesicoureteral Reflux

방광요관역류 환자에서 일과성 거짓저알도스테론증을 보인 6개월 소아 1 례

  • Kim, Moon-Kyu (Departments of Pediatrics, CHA Bundang Medical Center, CHA University) ;
  • Park, Sung-Eun (Departments of Pediatrics, CHA Bundang Medical Center, CHA University) ;
  • Lee, Jun-Ho (Departments of Pediatrics, CHA Bundang Medical Center, CHA University)
  • 김문규 (차의과학대학교 분당차병원 소아청소년과) ;
  • 박성은 (차의과학대학교 분당차병원 소아청소년과) ;
  • 이준호 (차의과학대학교 분당차병원 소아청소년과)
  • Received : 2012.02.02
  • Accepted : 2012.03.08
  • Published : 2012.04.30
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Abstract

A 6-month-old boy with vesicoureteral reflux exhibited features of transient type 1 pseudohypoaldosteronism (PHA) in the course of urinary tract infection. PHA presents hyponatremia, hyperkalemia, and metabolic acidosis, accompanying with high urinary sodium, low potassium excretion, and high plasma aldosterone concentration. Severe electrolyte disturbance can occur in an infant with vesicoureteral reflux because of secondary PHA. Appropriate treatment of dehydration and sodium supplementation induces rapid improvement of electrolyte imbalance and metabolic acidosis resulting from secondary PHA associated with vesicoureteral reflux.

요로감염환자에서 이차성 거짓저알도스테론증이 발생할 수 있다는 보고들이 흔하지 않게 보고되고 있다. 많은 경우들에서는 요로계통의 기형을 동반하였으나, 요로계기형이 없는 급성 신우신염 환자들에서도 거짓저알도스테론증의 발생이 보고되었다. 대부분의 경우들은 영아에서 발생하였다. 거짓저알도스테론증은 저나트륨혈증, 고칼륨혈증, 그리고 대사성 산증을 특징으로 심할 경우 치명적인 결과를 초래할 수 있다. 더군다나, 본 증례에서와 같이 전해질 불균형에 의한 증세가 식욕부진, 성장장애(failure to thrive) 등으로 미미할 경우 이차성 거짓저알도스테론증의 조기 진단이 어려울 수 있다. 세뇨관 기능이 아직 미숙하고, 요로감염의 발병율이 높은 영아에서는 요로감염으로 진단시 저나트륨혈증, 고칼륨혈증 등의 전해질 불균형의 동반 가능성을 염두에 두어야 할 것으로 사려된다.

Keywords

References

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