Alternate acidosis alkalosis

1. Hooman N
Professor of Pediatric Nephrology
Ali-asghar Children Hospital
IUMS 2021
Talebi S
Pediatrics- Medical Genetics
Ali-asghar Children Hospital
IUMS 2021
24.3.1400

2. presentation
3 wks ago poor feeding irritability vomiting post cough
2 wks ago >fever(38) productive cough watery diarrhea
lab test Na=132 K=2.4 > admitted
FH consang. PH- cleft lip repair 2m age
BP=90/50 T=37.2 RR=35 PR=120
PhE NL

3. Lab Test
WBC = 19200 (p=25) , Hb=11.4 , Plt=502000 ,ESR=6, CRP-ve
BS=107 , BUN=5 , Cr=0.6 , Ca=10, Ph=8.9, Mg=2.8, Alk=271
Na=131, K=2.5, Cl=117 , PH=7.48,Pco2=21.5, Hco3=15.8
Una=18.9, Ucr=24.8,Uk=6.7, Ucl=27,Uca=12.7,Up=6.8, Umg=3.4
FENa=0.17 , FEk= 3.46% , Uca/Ucr= 0.38 , FEPh=1.84 , UUA/Ucr= 1.72
Renin=550 ^ (x5 NL) , Aldostrone 361
U/A= PH=5, SG=1016, WBC, 3, RBC=8

4.  Renal ultrasound
 Microlithiasis 2mm RTK middle calyx

6. 2.5

7. 2.5
3.19

8. 2.5
3.19
High renin
Low aldo

9. 2.5
3.19
7.37/ 24/14
High renin
Low aldo

10. 2.5
3.19
7.37/ 24/14
High renin
Low aldo
7.54/28/23

11. 2.5
3.19
7.37/ 24/14
High renin
Low aldo
7.54/28/23
27

12. 2.5
3.19
7.37/ 24/14
High renin
Low aldo
7.54/28/23
27

14. Pedigree Tree

15. p.L1431*

18. p.L1431*