{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T14:40:39Z","timestamp":1787928039404,"version":"build-2784847793"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T00:00:00Z","timestamp":1637107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>Life-threatening electrolyte imbalance is not uncommon in preemies. Differential diagnosis is 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 the pediatric population result from urinary infection and obstructive uropathy and extremely rarely from gastrointestinal fluid loss. Seven preemies 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 reports 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.<\/jats:p>","DOI":"10.3389\/fped.2021.773246","type":"journal-article","created":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T02:20:33Z","timestamp":1637115633000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Case Report: Newborns With Pseudohypoaldosteronism Secondary to Excessive Gastrointestinal Losses Through High Output Stoma"],"prefix":"10.3389","volume":"9","author":[{"given":"Chia-Yu","family":"Ou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Ju","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geng-Bai","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei-Fan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Ti","family":"Chia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1016\/S0022-3476(89)80482-2","article-title":"Pseudohypoaldosteronism\u2014distinct disease or compensatory mechanism?","volume":"114","author":"Garbagnati","year":"1989","journal-title":"J Pediatr"},{"key":"B2","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1159\/000449057","article-title":"Water balance and 'salt wasting' in the first year of life: the role of aldosterone-signaling defects","volume":"86","author":"Bizzarri","year":"2016","journal-title":"Horm Res Paediatr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1097\/00006454-199501000-00012","article-title":"Acute pyelonephritis as a cause of hyponatremia\/hyperkalemia in young infants with urinary tract malformations","volume":"14","author":"Melzi","year":"1995","journal-title":"Pediatr Infect Dis J"},{"key":"B4","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.eucr.2016.07.001","article-title":"Secondary or transient pseudohypoaldosteronism associated with urinary tract anomaly and urinary infection: a case report","volume":"8","author":"Krishnappa","year":"2016","journal-title":"Urol Case Rep"},{"key":"B5","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1159\/000342508","volume":"24","author":"Riepe","year":"2013","journal-title":"Endocr Dev"},{"key":"B6","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/S0022-3468(88)80540-2","article-title":"Extensive aganglionosis: further experience with the colonic patch graft procedure and long-term results","volume":"23","author":"Kimura","year":"1988","journal-title":"J Pediatr Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000224334","article-title":"Clinical and molecular features of type 1 pseudohypoaldosteronism","volume":"72","author":"Riepe","year":"2009","journal-title":"Horm Res"},{"key":"B8","doi-asserted-by":"publisher","first-page":"2434","DOI":"10.1210\/jc.84.7.2434","article-title":"Polymorphisms of amiloride-sensitive sodium channel subunits in five sporadic cases of pseudohypoaldosteronism: do they have pathologic potential?","volume":"84","author":"Arai","year":"1999","journal-title":"J Clin Endocrinol Metab."},{"key":"B9","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1016\/j.ijpam.2019.04.001","article-title":"Life threatening hyperkalemia treated with prolonged continuous insulin infusion","volume":"6","author":"Awlad Thani","year":"2019","journal-title":"Int J Pediatr Adolesc Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1007\/BF02758269","article-title":"Salt wasting disorder in the newborn","volume":"73","author":"Ranjith","year":"2006","journal-title":"Indian J Pediatr"},{"key":"B11","doi-asserted-by":"publisher","first-page":"74","DOI":"10.3928\/00904481-20130426-09","article-title":"Failure to thrive, hyponatremia, and hyperkalemia in a neonate","volume":"42","author":"Sopfe","year":"2013","journal-title":"Pediatr Ann."},{"key":"B12","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1007\/BF03350891","article-title":"Transient pseudo-hypoaldosteronism following resection of the ileum: normal level of lymphocytic aldosterone receptors outside the acute phase","volume":"22","author":"Vantyghem","year":"1999","journal-title":"J Endocrinol Invest"},{"key":"B13","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1042\/cs0610407","article-title":"Water and electrolyte composition of urine and ileal fluid and its relationship to renin and aldosterone during dietary sodium deprivation in patients with ileostomies","volume":"61","author":"Moss","year":"1981","journal-title":"Clin Sci (Lond)"},{"key":"B14","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1159\/000185403","article-title":"Pseudohypoaldosteronism following resection of ileum and colon","volume":"51","author":"Sugawara","year":"1989","journal-title":"Nephron."},{"key":"B15","doi-asserted-by":"publisher","first-page":"361","DOI":"10.3109\/00365528509091665","article-title":"Sodium homeostasis after small-bowel resection","volume":"20","author":"Ladefoged","year":"1985","journal-title":"Scand J Gastroenterol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"729","DOI":"10.3109\/00365527909181945","article-title":"Fluid and electrolyte absorption and renin-angiotensin-aldosterone axis in patients with severe short-bowel syndrome","volume":"14","author":"Ladefoged","year":"1979","journal-title":"Scand J Gastroenterol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.pedneo.2020.09.006","article-title":"Three cases of pseudohypoaldosteronism following ileostomy in preterm infants","volume":"62","author":"Nakasone","year":"2021","journal-title":"Pediatr Neonatol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4172\/2161-0665.1000224","article-title":"Pseudohypoaldosteronism secondary to high output ileostomy: a unique report in an infant","volume":"5","author":"Alassaf","year":"2015","journal-title":"Pediatr Ther"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e5","DOI":"10.4158\/EP151011.CR","article-title":"A case of postileostomy hypovolemia presenting as pseudohypoaldosteronism with complete resolution after ostomy reversal","volume":"3","author":"Niyazov","year":"2017","journal-title":"AACE Clin Case Rep."},{"key":"B20","first-page":"487","article-title":"Potassium disorders: hypokalemia and hyperkalemia","volume":"92","author":"Viera","year":"2015","journal-title":"Am Fam Physician"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2021.773246\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T02:20:37Z","timestamp":1637115637000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2021.773246\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,17]]},"references-count":20,"alternative-id":["10.3389\/fped.2021.773246"],"URL":"https:\/\/doi.org\/10.3389\/fped.2021.773246","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,17]]},"article-number":"773246"}}