pp-89. neonatal bartter syndrome: case report

[27.0 (26.3–27.7) vs 30.1 (29.9–31.3) weeks] significantly lower thanVLBW. Acute kidney injury occurred with the same frequencybetween VLBW (4/43) and ELBW (3/26). At birth, ELBW were morefrequently treated with nephrotoxic drugs than VLBW: aminoglyco-sides (96.2% vs 46.5%) and ibuprofen (34.6% vs 7%).

Results

No differences were found for age, body surface area, bloodpressure, and renal function at follow-up. Urinary excretion of α1-microglobulin/creatinine was significantly higher in children bornELBW [0.16 (0.25–0.79) vs 0.00 (0.05–0.25) mg/mmol, P=0.008].Children born ELBW showed reduced renal volumes [73.8 (69.0–80.7) vs 86.3 (84.1–97.1) cm3], overall the left cortical thickness [1.00(0.96–1.10) vs 1.20 (1.11–1.29) cm]. Children who received post-natalaminoglycosides (45) showed comparable total renal volume(p=0.209) than who did not (24).

Conclusions

In conclusion, VLBW was associated with reduced renal volumes.Aminoglycoside administration at-birth was associated to an in-creased α1-microglobulin excretion at follow-up.

doi:10.1016/j.earlhumdev.2010.09.140

PP-88. Severe iatrogenic hyponatremia, with serum sodium85 mEq/L, in a newborn infant that was compatible with life

Faruk Alpay, Tolga Altug Şen, Evrim Gurhan Tahta,Hafza Ucur, Ali AksoyAfyon Kocatepe University Faculty of Medicine Neonatology Unit, Turkey

Aim

Here we pointed to iatrogenic hyponatremia and presented thatsevere hyponatremia may not result in death.

Case presentation

A male, preterm baby (birth weight 1.5 kg) with 30 gestationalweeks was referred to us on day 7 of life, with convulsions. He wasdiagnosed as respiratory distress syndrome and treated withmechanical ventilation during first 7 days of life in the state hospital.The baby was hypoactive, generalized hypotonia was remarkable andhe had frequent apnoea attacks, so we continued mechanicalventilation treatment. Serum sodium at admission was 85 mEq/L,potassium 2.7 mEq/L and chloride 51 mEq/L. Serum glucose, calcium,uric acid, urea, and blood urea nitrogen levels were normal. Urinesodium levels were normal (less than 15 mEq/L in multiple analysis),and urine osmolarity was <100 mOsm/L. No acidosis or alkalosis wasdetected and anionic gap was normal. Serum cortisol (11 μg/dL) and17-hydroxy progesterone levels (330 ng/dL) were normal. The babyhad been treated with hypotonic fluids (dextrose 5%) withoutmonitorizing serum electrolytes at the referring center. The patientwas treated with hypertonic (3%) saline initially since seizures werepresent and after that therapy was continued with intravenous 0.9%saline. The baby's hyponatremia was completely corrected by fluidreplacement in 3 days and seizures ceased.

Conclusion

Hyponatremia may result in serious central nervous system effectssuch as intracerebral hemorrhage, seizures, coma and extremely low

levels of sodiumand has been accepted as not be compatiblewith life. Inour case serum sodium level of 85 mEq/L didn't cause death.

doi:10.1016/j.earlhumdev.2010.09.141

PP-89. Neonatal Bartter syndrome: Case report

Neslihan Cicek Deniz, Turgut Agzıkuru, Yasemin Akın,Fatma Kaya Narter, Melek KoseDepartment of Pedıatrıcs, Dr. Lütfi Kırdar Kartal Traınıng and ResearchHospıtal, Istanbul, Turkey

Aim

Bartter syndrome is a rare form of hypokalemic metabolic alkalosiswith hypercalciuria, with an autosomal recessive pattern of inheritance.Two distinct clinical subtypes of Bartter syndrome are seen. AntenatalBartter syndrome, is typically present in infancy and has a more severephenotype than classic Bartter syndrome, including polyhydramnios,salt wasting and severe dehydration. We are reporting here, a case ofBartter syndrome diagnosed in the neonatal period.

Case presentation

A34 weekpremature babywasborn1410 gwith respiratuardistress.The mother was G3P2 and had polyhydramnios during pregnancy. Thecase did not showa satisfactoryweight gain in the first twoweeks of life,in spite of supervised feeding. The metabolic parameters revealedhypokalemia, hypochloremic metabolic alkalosis with hyponatremia.Further investigations showed excessive loss of sodium, potassium,calcium and chloride in urine. The child was normotensive. Henceneonatal Bartter syndromewas suspected. The diagnosiswas confirmedby raised plasma renin activity and plasma aldosterone level. Treatmentwas done by correction of electrolytes and dehydration. The child wasexcitus on the 38th day of life because of sepsis.

Conclusion

This casewas reported because of its rarity and to alert pediatriciansto the antenatal and neonatal variant of Bartter syndrome.

doi:10.1016/j.earlhumdev.2010.09.142

PP-90. Comparison of mortality and morbidity of preterm infantsin multiple versus singleton pregnancies

Ayse Ecevita, Beril Ozdemira, Deniz Anuk İncea, Abdullah Kurta,b,Aylin Tarcana, Filiz F YanıkcaBaskent University Faculty of Medicine, Department of Pediatrics,Division of Neonatology, TurkeybDepartment of Pediatrics, Ankara, TurkeycDepartment of Obstetrics and Gynecology, Ankara, Turkey

Aim

The aim of the current study is to analyze neonatal mortality andmorbidity of preterm infants in multiple versus singleton pregnanciesat the same gestational weeks and birth weight.

Materials and methods

We performed a retrospective study at Baskent UniversityHospital between January 2008 and January 2010. We compared

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