Table 3.
Characteristic of infants with hypoaldosterone and aldosterone resistance
| Investigation | Patient 1 | Patient 2 | Patient 3 | Patient 4 | Patient 5 |
|---|---|---|---|---|---|
| Age | 14 days | 14 days | 7 days | 21 days | 7 days |
| Manifestation | Recurrent vomiting, diarrhea, poor feeding | Recurrent vomiting, diarrhea, poor feeding | Recurrent vomiting, poor feeding | Poor feeding | Poor feeding, failure to thrive |
|
Plasma Na [NR 135 ~ 145 mmol/L] |
130 | 130 | 132 | 115 | 131 |
|
Plasma K [NR 3.5 ~ 5.0 mmol/L] |
6.86 | 6.17 | 6.2 | 6.73 | 5.88 |
|
Plasma ACTH [NR 1.6 ~ 13.9 pmol/L] |
3.37 | 2.93 | 1.92 | 4.95 | 7.22 |
|
Plasma cortisol [NR 5 ~ 20μg/dl] |
< 5 | 10.5 | 3.5 | n.a | 7.7 |
|
Plasma PRA [NRa] |
1019.2 | n.a | 1287 | high | High |
|
Plasma Ald [NRb] |
117.0 | n.a | 672.11 | 66.51 | 1566.79 |
| Adrenal imaging | normal | normal | n.a | n.a | Hyperplasia |
| Gene mutation |
CYP11B2 Heterozygous c.1121G > A (p.R374Q), c.1486delC p.(L496fs) |
CYP11B2 Heterozygous c.1121G > A (p.R374Q), c.1486delC p.(L496fs) |
CYP11B2 Homozygous c.1303G > A p.(G435S) |
CYP11B2 Heterozygous c.1200 + 1G > A, c.240-1G > T |
NR3C2 Heterozygous c.1768C > T, p.(R590*) |
| Diagnosis | ASD | ASD | ASD | ASD | PHA1 |
Na sodium, K potassium, PRA plasma renin activity, ACTH Adrenocorticotropic hormone, Ald Aldosterone, n.a not available, NR normal range, Age age at presentation, ASD aldosterone synthase deficiency, PHA1 pseudohypoaldosteronism type 1
aAdult: 4-24 pg/ml, Neonatal renin is high, which can be 2.5–20 times higher than that of adults, and these values slowly decline but high values can be seen up until the age of 5 years [10]
bNewborn: 10-1800 pg/ml, infant 1-12 month 50-900 pg/ml