0 9 Transient transient JJ 10 34 pseudo-hypoaldosteronism pseudo-hypoaldosteronism NN 35 44 following follow VBG 45 54 resection resection NN 55 57 of of IN 58 61 the the DT 62 67 ileum ileum NN 67 68 : : : 69 75 normal normal JJ 76 81 level level NN 82 84 of of IN 85 96 lymphocytic lymphocytic JJ 97 108 aldosterone aldosterone NN 109 118 receptors receptor NNS 119 126 outside outside IN 127 130 the the DT 131 136 acute acute JJ 137 142 phase phase NN 142 143 . . . 145 169 Pseudo-hypoaldosteronism Pseudo-hypoaldosteronism NNP 170 171 ( ( ( 171 174 PHA PHA NNP 174 175 ) ) ) 176 178 is be VBZ 179 182 due due JJ 183 185 to to TO 186 203 mineralocorticoid mineralocorticoid NN 204 214 resistance resistance NN 215 218 and and CC 219 228 manifests manifest VBZ 229 231 as as IN 232 244 hyponatremia hyponatremia NN 245 248 and and CC 249 261 hyperkalemia hyperkalemia NN 262 266 with with IN 267 276 increased increase VBN 277 283 plasma plasma NN 284 295 aldosterone aldosterone NN 296 302 levels level NNS 302 303 . . . 304 306 It it PRP 307 310 may may MD 311 313 be be VB 314 322 familial familial JJ 323 325 or or CC 326 335 secondary secondary JJ 336 338 to to TO 339 347 abnormal abnormal JJ 348 353 renal renal JJ 354 360 sodium sodium NN 361 369 handling handling NN 369 370 . . . 371 373 We we PRP 374 380 report report VBP 381 384 the the DT 385 389 case case NN 390 392 of of IN 393 394 a a DT 395 406 54-year-old 54-year-old JJ 407 412 woman woman NN 413 417 with with IN 418 428 multifocal multifocal JJ 429 435 cancer cancer NN 436 438 of of IN 439 442 the the DT 443 448 colon colon NN 448 449 , , , 450 453 who who WP 454 463 developed develop VBD 464 467 PHA PHA NNP 468 473 after after IN 474 482 subtotal subtotal JJ 483 492 colectomy colectomy NN 492 493 , , , 494 499 ileal ileal JJ 500 509 resection resection NN 510 513 and and CC 514 525 jejunostomy jejunostomy NN 525 526 . . . 527 530 She she PRP 531 534 was be VBD 535 542 treated treat VBN 543 547 with with IN 548 549 6 6 CD 550 551 g g NN 552 554 of of IN 555 559 salt salt NN 560 565 daily daily JJ 566 568 to to TO 569 576 prevent prevent VB 577 588 dehydration dehydration NN 588 589 , , , 590 595 which which WDT 596 599 she she PRP 600 607 stopped stop VBD 608 615 herself herself PRP 616 623 because because IN 624 626 of of IN 627 634 reduced reduce VBN 635 640 fecal fecal JJ 641 647 losses loss NNS 647 648 . . . 649 652 One one CD 653 658 month month NN 659 664 later later RB 665 668 she she PRP 669 672 was be VBD 673 681 admitted admit VBN 682 686 with with IN 687 692 signs sign NNS 693 695 of of IN 696 701 acute acute JJ 702 709 adrenal adrenal JJ 710 717 failure failure NN 717 718 , , , 719 723 i.e. i.e. FW 724 731 fatigue fatigue NN 731 732 , , , 733 739 severe severe JJ 740 746 nausea nausea NN 746 747 , , , 748 753 blood blood NN 754 762 pressure pressure NN 763 765 of of IN 766 771 80/60 80/60 CD 772 776 mmHg mmhg NN 776 777 , , , 778 791 extracellular extracellular JJ 792 803 dehydration dehydration NN 803 804 , , , 805 817 hyponatremia hyponatremia NN 818 819 ( ( ( 819 822 118 118 CD 823 829 mmol/l mmol/l NN 829 830 ) ) ) 830 831 ; ; : 832 844 hyperkalemia hyperkalemia NN 845 846 ( ( ( 846 849 7.6 7.6 CD 850 856 mmol/l mmol/l NN 856 857 ) ) ) 857 858 , , , 859 868 increased increase VBN 869 874 blood blood NN 875 879 urea urea NN 880 888 nitrogen nitrogen NN 889 890 ( ( ( 890 893 BUN BUN NNP 893 894 ) ) ) 895 896 ( ( ( 896 899 200 200 CD 900 905 mg/dl mg/dl NN 905 906 ) ) ) 907 910 and and CC 911 924 creatininemia creatininemia NN 925 926 ( ( ( 926 929 2.5 2.5 CD 930 935 mg/dl mg/dl NN 935 936 ) ) ) 936 937 , , , 938 941 and and CC 942 951 decreased decrease VBN 952 958 plasma plasma NN 959 971 bicarbonates bicarbonate NNS 972 977 level level NN 978 979 ( ( ( 979 984 HCO3- HCO3- NNP 984 985 : : : 986 988 16 16 CD 989 995 mmol/l mmol/l NN 995 996 ; ; : 997 998 N N NNP 998 999 : : : 1000 1005 27-30 27-30 CD 1005 1006 ) ) ) 1006 1007 . . . 1008 1015 However however RB 1015 1016 , , , 1017 1020 the the DT 1021 1027 plasma plasma NN 1028 1036 cortisol cortisol NN 1037 1040 was be VBD 1041 1045 high high JJ 1046 1047 ( ( ( 1047 1049 66 66 CD 1050 1060 microg/100 microg/100 NN 1061 1063 ml ml NN 1064 1066 at at IN 1067 1072 10:00 10:00 CD 1073 1074 h h NN 1074 1075 ; ; : 1076 1077 N N NNP 1077 1078 : : : 1079 1083 8-15 8-15 CD 1083 1084 ) ) ) 1085 1088 and and CC 1089 1092 the the DT 1093 1097 ACTH acth NN 1098 1101 was be VBD 1102 1108 normal normal JJ 1109 1110 ( ( ( 1110 1112 13 13 CD 1113 1118 pg/ml pg/ml NN 1118 1119 , , , 1120 1121 N N NNP 1121 1122 : : : 1123 1128 10-60 10-60 CD 1128 1129 ) ) ) 1129 1130 ; ; : 1131 1136 there there EX 1137 1140 was be VBD 1141 1142 a a DT 1143 1149 marked marked JJ 1150 1158 increase increase NN 1159 1161 in in IN 1162 1168 plasma plasma NN 1169 1174 renin renin NN 1175 1183 activity activity NN 1184 1185 ( ( ( 1185 1188 >37 >37 CD 1189 1196 ng/ml/h ng/ml/h NN 1196 1197 ; ; : 1198 1199 N N NNP 1200 1206 supine supine NN 1207 1209 <3 <3 NN 1209 1210 ) ) ) 1210 1211 , , , 1212 1218 active active JJ 1219 1224 renin renin NN 1225 1226 ( ( ( 1226 1229 869 869 CD 1230 1235 pg/ml pg/ml NN 1235 1236 ; ; : 1237 1238 N N NNP 1239 1245 supine supine NN 1245 1246 : : : 1247 1252 1.120 1.120 CD 1252 1253 ) ) ) 1253 1254 , , , 1255 1266 aldosterone aldosterone NN 1267 1268 ( ( ( 1268 1273 >2000 >2000 CD 1274 1279 pg/ml pg/ml NN 1279 1280 ; ; : 1281 1282 N N NNP 1283 1289 supine supine NN 1290 1294 <150 <150 NN 1294 1295 ) ) ) 1296 1299 and and CC 1300 1306 plasma plasma NN 1307 1310 AVP AVP NNP 1311 1312 ( ( ( 1312 1314 20 20 CD 1315 1321 pmol/l pmol/l NN 1321 1322 ; ; : 1323 1324 N N NNP 1324 1325 : : : 1326 1333 0.5-2.5 0.5-2.5 CD 1333 1334 ) ) ) 1334 1335 . . . 1336 1339 The the DT 1340 1346 plasma plasma NN 1347 1350 ANH ANH NNP 1351 1356 level level NN 1357 1360 was be VBD 1361 1363 38 38 CD 1364 1370 pmol/l pmol/l NN 1371 1372 ( ( ( 1372 1373 N N NNP 1374 1380 supine supine NN 1380 1381 : : : 1382 1386 5-25 5-25 CD 1386 1387 ) ) ) 1387 1388 . . . 1389 1390 A a DT 1391 1398 urinary urinary JJ 1399 1411 steroidogram steroidogram NN 1412 1420 resulted result VBD 1421 1423 in in IN 1424 1430 highly highly RB 1431 1439 elevated elevated JJ 1440 1458 tetrahydrocortisol tetrahydrocortisol NN 1459 1460 ( ( ( 1460 1463 THF THF NNP 1463 1464 : : : 1465 1469 13.3 13.3 CD 1470 1476 mg/24h mg/24h NN 1476 1477 ; ; : 1478 1479 N N NNP 1479 1480 : : : 1481 1490 1.4+/-0.8 1.4+/-0.8 CD 1490 1491 ) ) ) 1492 1496 with with IN 1497 1499 no no DT 1500 1508 increase increase NN 1509 1511 in in IN 1512 1531 tetrahydrocortisone tetrahydrocortisone NN 1532 1533 ( ( ( 1533 1536 THE the DT 1536 1537 : : : 1538 1542 3.16 3.16 CD 1543 1549 mg/24h mg/24h NN 1549 1550 ; ; : 1551 1552 N N NNP 1552 1553 : : : 1554 1563 2.7+/-2.0 2.7+/-2.0 CD 1563 1564 ) ) ) 1565 1574 excretion excretion NN 1574 1575 , , , 1576 1579 and and CC 1580 1584 with with IN 1585 1588 low low JJ 1589 1596 THE/THF THE/THF NNP 1597 1598 ( ( ( 1598 1602 0.24 0.24 CD 1602 1603 ; ; : 1604 1605 N N NNP 1605 1606 : : : 1607 1618 1.87+/-0.36 1.87+/-0.36 CD 1618 1619 ) ) ) 1620 1623 and and CC 1624 1629 alpha alpha NN 1630 1637 THF/THF thf/thf NN 1638 1639 ( ( ( 1639 1643 0.35 0.35 CD 1643 1644 ; ; : 1645 1646 N N NNP 1646 1647 : : : 1648 1659 0.92+/-0.42 0.92+/-0.42 CD 1659 1660 ) ) ) 1661 1667 ratios ratio NNS 1667 1668 . . . 1669 1672 The the DT 1673 1679 number number NN 1680 1682 of of IN 1683 1700 mineralocorticoid mineralocorticoid NN 1701 1710 receptors receptor NNS 1711 1713 in in IN 1714 1725 mononuclear mononuclear JJ 1726 1736 leukocytes leukocyte NNS 1737 1740 was be VBD 1741 1743 in in IN 1744 1747 the the DT 1748 1753 lower low JJR 1754 1760 normal normal JJ 1761 1766 range range NN 1767 1770 for for IN 1771 1774 age age NN 1774 1775 , , , 1776 1781 while while IN 1782 1785 the the DT 1786 1792 number number NN 1793 1795 of of IN 1796 1810 glucocorticoid glucocorticoid NN 1811 1820 receptors receptor NNS 1821 1824 was be VBD 1825 1832 reduced reduce VBN 1832 1833 . . . 1834 1845 Small-bowel small-bowel JJ 1846 1855 resection resection NN 1856 1858 in in IN 1859 1871 ileostomized ileostomized JJ 1872 1880 patients patient NNS 1881 1887 causes cause VBZ 1888 1897 excessive excessive JJ 1898 1903 fecal fecal JJ 1904 1910 sodium sodium NN 1911 1917 losses loss NNS 1918 1921 and and CC 1922 1929 results result VBZ 1930 1932 in in IN 1933 1940 chronic chronic JJ 1941 1947 sodium sodium NN 1948 1957 depletion depletion NN 1958 1962 with with IN 1963 1974 contraction contraction NN 1975 1977 of of IN 1978 1981 the the DT 1982 1988 plasma plasma NN 1989 1995 volume volume NN 1996 1999 and and CC 2000 2006 severe severe JJ 2007 2016 secondary secondary JJ 2017 2035 hyperaldosteronism hyperaldosteronism NN 2035 2036 . . . 2037 2049 Nevertheless nevertheless RB 2049 2050 , , , 2051 2055 this this DT 2056 2074 hyperaldosteronism hyperaldosteronism NN 2075 2078 may may MD 2079 2081 be be VB 2082 2092 associated associate VBN 2093 2097 with with IN 2098 2110 hyponatremia hyponatremia NN 2111 2114 and and CC 2115 2127 hyperkalemia hyperkalemia NN 2128 2138 suggesting suggest VBG 2139 2142 PHA PHA NNP 2143 2150 related related JJ 2151 2153 to to TO 2154 2157 the the DT 2158 2163 major major JJ 2164 2174 importance importance NN 2175 2177 of of IN 2178 2181 the the DT 2182 2187 colon colon NN 2188 2191 for for IN 2192 2195 the the DT 2196 2206 absorption absorption NN 2207 2209 of of IN 2210 2216 sodium sodium NN 2216 2217 . . . 2218 2220 In in IN 2221 2231 conclusion conclusion NN 2231 2232 , , , 2233 2237 this this DT 2238 2242 case case NN 2243 2249 report report NN 2250 2260 emphasizes emphasize VBZ 2261 2262 1 1 LS 2262 2263 ) ) ) 2264 2267 the the DT 2268 2279 possibility possibility NN 2280 2282 of of IN 2283 2284 a a DT 2285 2293 syndrome syndrome NN 2294 2296 of of IN 2297 2305 acquired acquire VBN 2306 2309 PHA PHA NNP 2310 2314 with with IN 2315 2321 severe severe JJ 2322 2334 hyperkalemia hyperkalemia NN 2335 2340 after after IN 2341 2350 resection resection NN 2351 2353 of of IN 2354 2357 the the DT 2358 2363 ileum ileum NN 2364 2367 and and CC 2368 2373 colon colon NN 2374 2384 responding respond VBG 2385 2387 to to TO 2388 2392 oral oral JJ 2393 2397 salt salt NN 2398 2413 supplementation supplementation NN 2413 2414 ; ; : 2415 2416 2 2 LS 2416 2417 ) ) ) 2418 2421 the the DT 2422 2427 major major JJ 2428 2436 increase increase NN 2437 2439 in in IN 2440 2443 AVP AVP NNP 2444 2447 and and CC 2448 2451 the the DT 2452 2457 small small JJ 2458 2466 increase increase NN 2467 2469 in in IN 2470 2473 ANH ANH NNP 2473 2474 ; ; : 2475 2476 3 3 LS 2476 2477 ) ) ) 2478 2481 the the DT 2482 2488 strong strong JJ 2489 2497 increase increase NN 2498 2500 in in IN 2501 2508 urinary urinary JJ 2509 2512 THF thf NN 2513 2517 with with IN 2518 2521 low low JJ 2522 2529 THE/THF the/thf NN 2530 2533 and and CC 2534 2539 alpha alpha NN 2540 2547 THF/THF thf/thf NN 2548 2554 ratios ratio NNS 2554 2555 ; ; : 2556 2557 4 4 LS 2557 2558 ) ) ) 2559 2562 the the DT 2563 2569 normal normal JJ 2570 2576 number number NN 2577 2579 of of IN 2580 2591 lymphocytic lymphocytic JJ 2592 2609 mineralocorticoid mineralocorticoid NN 2610 2619 receptors receptor NNS 2620 2627 outside outside IN 2628 2631 the the DT 2632 2637 acute acute JJ 2638 2645 episode episode NN 2645 2646 . . .