AUTHOR=Ou Chia-Yu , Chen Yen-Ju , Lin Geng-Bai , Chen Mei-Fan , Chia Shu-Ti 

TITLE=Case Report: Newborns With Pseudohypoaldosteronism Secondary to Excessive Gastrointestinal Losses Through High Output Stoma

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 9 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.773246

DOI=10.3389/fped.2021.773246

ISSN=2296-2360

ABSTRACT=Life threatening electrolyte imbalance is not uncommon in preemies. Differential diagnosis was
important for immediate treatment. The syndrome of pseudohypoaldosteronism (PHA) is
characterized by increased aldosterone secretion associated with clinical signs of hypoaldosteronism 
reflecting mineralocorticoid resistance. There are type I, type II and secondary type of PHA. Most 
secondary PHA reported in pediatric population resulted from urinary infection and obstructive 
uropathy and extremely rare from gastrointestinal fluid loss.
Seven premies accepted jejunostomy or ileostomy, and they suffered from high output stoma.
Electrolyte imbalance with bodyweight loss or cardiac event was noted. We found a high-level of 
aldosterone and renin and diagnosed them with secondary PHA due to excessive gastrointestinal 
losses. After stomal reversal, aldosterone and renin level became normalized and electrolyte was 
corrected.This study reporting the finding of secondary pseudohyperaldosteronism (hyponatremia, 
hyperkalemia and metabolic acidosis) in a series of cases with intestinal resection and ostomy of 
different causes. Early stomal reversal was recommended.