A novel mutation of the epithelial Na+ channel causes type 1 pseudohypoaldosteronism

Type I pseudohypoaldosteronism (PHA-1) is a rare salt wasting syndrome occurring soon after birth, characterized by apathy and severe dehydration accompanied by hyponatremia, hyperkalemia, and metabolic acidosis despite high plasma aldosterone concentrations. The molecular defect involved in the systemic autosomal recessive form of the syndrome has been identified. Mutations in all three genes encoding the epithelial sodium channel (ENaC) lead to a decrease in the channel function, resulting in the disease. We report here two new cases of the autosomal recessive form of PHA-1 in the same family. We found a new homozygous mutation of the gene encoding the alpha ENaC subunit (alphaR492stop). The function of the mutated ENaC channel was assessed in the Xenopus laevis oocyte expression system. The mutant ENaC activity measured with the two-electrode voltage clamp method was drastically decreased compared with the wild type activity, in agreement with the saltlosing phenotype.