Changes in behavior as an early symptom of renovascular hypertension in children.
Renovascular hypertension in children is usually asymptomatic and diagnosed incidentally. Behavioral changes have not yet been well recognized as a part of the clinical spectrum of renovascular disease in children. We surveyed all children diagnosed with renovascular hypertension in our institute over a 15-year period. Eleven children were identified, of whom five (45%) had abnormal behavior, which had preceded the diagnosis of hypertension by 3-12 months. The symptoms included restlessness, sleep disturbances, temper tantrums, hyperactivity, aggressive behavior and attention deficit. In three children all behavioral symptoms disappeared following blood pressure normalization, and, in the other two a significant improvement was noted. It was concluded that behavioral symptoms may be a common and early manifestation of renovascular hypertension. Awareness of this association may bring about earlier diagnosis of the disease and prevent end-organ damage as well as unnecessary investigations for behavioral abnormalities.
Krause
Irit
I
Pediatric Nephrology Institute, Schneider's Children Medical Center of Israel, Petah-Tiqva, Israel. ikrause@post.tau.ac.il
Cleper
Roxana
R
Kovalski
Yael
Y
Sinai
Levana
L
Davidovits
Miriam
M
D000792:Angiography / Q000379:methods; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001262:Atenolol / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis*; D002653:Child Behavior Disorders / Q000175:diagnosis*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis*; D007741:Labetalol / Q000627:therapeutic use; D009543:Nifedipine / Q000627:therapeutic use; D012077:Renal Artery / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
D000959:Antihypertensive Agents; D014665:Vasodilator Agents; D001262:Atenolol; D009543:Nifedipine; D007741:Labetalol