Autoimmune encephalitis caused by antibodies to membrane and synaptic antigens

  • Alenka Stepišnik Splošna bolnišnica Izola Oddelek za pediatrijo Polje 40 6310 Izola
  • Irena Cetin-Lovšin Splošna bolnišnica Izola Oddelek za pediatrijo Polje 40 6310 Izola
  • Sonja Posega-Devetak Splošna bolnišnica Izola Oddelek za pediatrijo Polje 40 6310 Izola
DOI: https://doi.org/10.6016/ZdravVestn.1888
Keywords: aldosteron, pseudohypoaldosteronism, newborn, hyponatremia, hyperkalemia

Abstract

Hiponatremia and hyperkalemia in a newborn can be a life threatening disorder caused by different diseases, including congenital adrenal hyperplasia, or less frequently by a genetical or acquired tubular cell resistance to aldosteron, called pseudohypoaldosteronism. Secondary pseudohypoaldosteronism is a rare, reversible electrolyte disorder caused by aldosterone resistance in infants with congenital urinary tract malformations and/or urinary tract infection.

We present a 4-week-old boy with severe hyponatremia, hyperkalemia and elevated aldosterone levels during an episode of pyelonephritis. The disorder improved completely with antibiotic treatment, rehydration and electrolyte correction. Further investigations showed no structural urinary tract anomalies. According to the literature, we concluded that electrolyte disturbances were caused by aldosterone resistance of the inflamed tubular cells and subsequent defective transepithelial sodium transport.

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References

Kotnik P, Battelino T. Motnje v delovanju nadledvičnih žlez. In: Kržišnik C, ur. Pediatrija. Ljubljana: DZS; 2014. p. 504–6.

Ruiz Ginés MÁ, Ruiz Ginés JA, Saura Montalbán J, Fontelles Alcover R, Piqueras Martínez AN. Pseudohypoaldosteronism type 1 secondary to vesicoureteral reflux: An endocrinologic emergency. Endocrinología y Nutrición (English Edition). 2014;61(9):495–7.

Martinerie L, Pussard E, Foix-L’Hélias L, Petit F, Cosson C, Boileau P, et al. Physiological Partial Aldosterone Resistance in Human Newborns. Pediatric Research. 2009;66(3):323–8.

Martinerie L, Viengchareun S, Delezoide A-L, Jaubert F, Sinico M, Prevot S, et al. Low Renal Mineralocorticoid Receptor Expression at Birth Contributes to Partial Aldosterone Resistance in Neonates. Endocrinology. 2009;150(9):4414–24.

Rajpoot SK, Maggi C, Bhangoo A. Pseudohypoaldosteronism in a neonate presenting as life-threatening arrhythmia. Endocrinology, Diabetes & Metabolism Case Reports. 2014.

Amin N, Alvi NS, Barth JH, Field HP, Finlay E, Tyerman K, et al. Pseudohypoaldosteronism type 1: clinical features and management in infancy. Endocrinology, Diabetes & Metabolism Case Reports. 2013.

Kostakis ID, Cholidou KG, Vaiopoulos AG, Vlachos IS, Perrea D, Vaos G. Fecal Calprotectin in Pediatric Inflammatory Bowel Disease: A Systematic Review. Digestive Diseases and Sciences. 2012;58(2):309–19.

Güran T, Değirmenci S, Bulut İK, Say A, Riepe FG, Güran Ö. Critical Points in the Management of Pseudohypoaldosteronism Type 1–Case Report. journal of Clinical Research in Pediatric Endocrinology. 2011;3(2):98–100.

Bogdanović R, Stajić N, Putnik J, Paripović A. Transient type 1 pseudo-hypoaldosteronism: report on an eight-patient series and literature review. Pediatric Nephrology. 2009;24(11):2167–75.

Maruyama K, Watanabe H, Onigata K. Reversible secondary pseudohypoaldosteronism due to pyelonephritis. Pediatr Nephrol 2002;17(12):1069‒70.

Llana I, Sanchez-Redondo M, Benedit M, Cobas J, Alvaro MGd. 960 Secondary Pseudohypoaldosteronism Due to Pyelonephritis: Two Cases Report. Archives of Disease in Childhood. 2012;97(Suppl 2):A274-A.

Nandagopal R, Vaidyanathan P, Kaplowitz P. Transient Pseudohypoaldosteronism due to Urinary Tract Infection in Infancy: A Report of 4 Cases. International Journal of Pediatric Endocrinology. 2009;2009:1–4.

Rodríguez-Soriano J, Vallo A, Oliveros R, Castillo G. Transient pseudohypoaldosteronism secondary to obstructive uropathy in infancy. The Journal of Pediatrics. 1983;103(3):375–80.

Asano T, Abe M, Asai M, Imai T, Kamisago M, Kuwabara K, et al. Urinary Tract Malformation and Infection with Hyperkalemia and Decreased Fractional Excretion of Potassium in an Infant. Journal of Nippon Medical School. 2006;73(5):289-91.

Published
2017-06-05
How to Cite
1.
Stepišnik A, Cetin-Lovšin I, Posega-Devetak S. Autoimmune encephalitis caused by antibodies to membrane and synaptic antigens. TEST ZdravVestn [Internet]. 5Jun.2017 [cited 19Apr.2024];86. Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/1888
Issue
Vol 86 (2017): Supplement I
Section
Case report, short scientific article


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