title: Changes in behavior as an early symptom of renovascular hypertension in children.
abstract: 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.
authors.affiliation: Pediatric Nephrology Institute, Schneider's Children Medical Center of Israel, Petah-Tiqva, Israel. ikrause@post.tau.ac.il
authors.forename: Irit
authors.initials: I
authors.lastname: Krause
authors.forename: Roxana
authors.initials: R
authors.lastname: Cleper
authors.forename: Yael
authors.initials: Y
authors.lastname: Kovalski
authors.forename: Levana
authors.initials: L
authors.lastname: Sinai
authors.forename: Miriam
authors.initials: M
authors.lastname: Davidovits
mesh_terms: 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
chemical_list: D000959:Antihypertensive Agents; D014665:Vasodilator Agents; D001262:Atenolol; D009543:Nifedipine; D007741:Labetalol