Secondary Pseudohypoaldosteronism: Salt Wasting in Infant with Posterior Urethral Valves

Introduction: One of the uncommon diseases and serious one in an infant is hyponatremia with hyperkalemia. Secondary Pseudo hypoaldosteronism (PHA) is congenital adrenal hyperplasia that has been described in babies with urinary tract infection (UTI) and urinary tract malformation (UTM). Case presentation: Here, we report a CRE guideline-based case of a 39 days infant with failure to thrive and lastly identified with transient PHA because of UTI with posterior urethral valves. Congenital adrenal hyperplasia was excluded in front of cortisol; 17 OH progesterone and adrenocorticotropic hormone (ACTH) were within normal ranges. The infant was put under double antibiotic and sodium replacement therapy and cation exchange resin at the rate of one gram per kilogram, and after stabilizing his clinical condition and sterilizing the urine, the infant underwent endoscopic valve resection. Conclusion: Transient secondary type 1 PHA caused by a UTI should be considered in the existence of hyponatremia, hyperkalemia, and metabolic acidosis in newborns with UTI and UTM.