A l0-month-old boy, weighing 3 kg has polyuria, polydipsia and delayed motor milestones. Investigations show blood levels of creatinine 0.5 mg/ dl, potassium 3 mEq/L, sodium 125 mE,qlL, chloride 88 mEq/L, calcium 8.8 mg/ dI, pH 7.46 and bicarbonate 26 mEq/L. Ultrasonography shows medullary nephrocalcinosis. The most likety diagnosis is - (AIIMS Nov 2014)
|A||Renal tubular acidosis|
a. For Bartter syndrome, see above explanation
About other options
b. Renal tubular acidosis
i. It can be easily ruled out because the patient mentioned in the question presents with alkalosis
c. Diabetes insipidus
i. In diabetes insipidus there is loss of water in the urine as a consequence the concentration of sodium and potassium is increased.
Aldosterone level is normal or increased but there are features of aldosterone deficiency such as decreased sodium and increased potassium.
Hemolytic uremic syndrome