A Reversible Salt-wasting Syndrome of the Newborn and Infant: Possible Infantile Hypoaldosteronism

Abstract

Two children are presented in whom a salt-wasting syndrome was manifest from birth, although spontaneously reversible when tided over their first year or so with the help of D.C.A. and salt supplementation. Their salt depletion was reflected clinically in anorexia and vomiting, with arrest of weight gain until treated. Hyper-irritability was conspicuous, and increasing hypotonia, dehydration and episodes of collapse and pallor culminated in peripheral circulatory failure. In both cases there was hyponatremia and hyperkalemia similar to that found in panhypoadrenocorticism or adrenogenital salt-losing, although both lacked other specific criteria of either disorder. Restoration of apparent clinical and biochemical normality depended upon supplementation with both D.C.A. and salt. Until full functional recovery or compensation is established, withdrawal of either promptly leads to relapse.