-- turn out your toes as you walk -- and remember who you are!’ She did not wait for Alice to curtsey this time, but walked on quickly to the next peg, where she turned for a moment to say `good-bye,’ and then hurried on to the last.

Hi Tom,

It does sound rare and I can understand the confusion and not knowing what is happening and hoping that they have a wrong diagnosis.    Hopefully though  it will be simpler than CAH to treat because in CAH it means replacing two enzymes... Aldosterone and Cortisol as you already know.  

What I  am not clear on is what Carol said about the ’receiving’ part.  Breaking  it down....that   sounds like even oral replacement to someone with that condition would not be able to receive it?    That sounds then not like an adrenal problem but a pituitary problem as it is the pituitary that acts upon receptor cells and decides whether there is enough aldosterone or more is needed.   Or is it the receptor cell itself that is faulty and not having the right "key" to stop the pituitary from releasing ACTH?

If that is what it is then aldosterone would be made in large amounts but simply not detected as being at high levels in the blood by the pituitary, which would then explain symptoms such as hypertension stated in that article.

Or when it says pseudo...is it meaning that it is "false"  hypoaldosteronism because it "mimicks the real thing only because of some type of blockage in a tubule or something and that this resolves itself when a blockage was cleared that the whole thing resolved itself and that it was not an enzyme  deficiency causing the hypoaldosteronism, but a "physical"  blockage due to deposits, that when cleared sorted the problem out.  In that case, once rectified...there would be no replacement aldosterone needed which has got to be good news?

" His electrolytes improved to normal after relieving the obstruction by vesicostomy and his treatment weaned slowly without complications. This case demonstrates the importance of urine culture and ultrasound examination in suspected cases of pseudo-hypoaldosteronism."

Hope that they get to the botom of it and things turn out well for your guys anyway.

Anne-Marie