Liddle Syndrome

It is a genetic kidney disease with autosomal dominant inheritance, which usually manifests itself in adolescence or adulthood. The symptoms are the same as in primary hyperaldosteronism, but the aldosterone level is not elevated. That is why we are talking about pseudohyperaldosteronism.

Pathogenesis
The cause is a mutation in the gene for the subunits of sodium channels on the luminal side of the cells of the renal collecting duct (so-called ENaC channel). There are more channels in the renal tubules and they are hyperactive due to the mutation. Thus, more Na + is absorbed from the urine as in the case of Aldosterone.

Clinical Picture
Manifestations of the disease include hypertension, hypokalemia, metabolic alkalosis, hypernatremia, polyuria, thirst, failure to thrive. From laboratory tests we find reduced or normal levels of aldosterone and renin.

Treatment
We supply the patient with potassium in the form of potassium salts. The main drug is triamterene, a potassium-sparing diuretic, that inhibits Na+ channel activity or amiloride. Spironolactone has no effect here. Salt restriction is recommended.

Related articles

 * Aldosterone
 * Primary hyperaldosteronism
 * Hypokalemia