title: Severe visual loss caused by unrecognized malignant hypertension in a 15-year-old girl.
abstract: A 15-year-old girl presented with acute bilateral loss of central visual acuity due to hypertensive retinopathy level IV. She was found to have unrecognized malignant arterial hypertension associated with end-stage renal failure. At the time of diagnosis she also had severe left ventricular hypertrophy (LVH). Hypertension was successfully treated with combined anti-hypertensive therapy, but renal function did not recover. The patient underwent successful kidney transplant 4 months later and over a period of 20 months hypertensive retinopathy and LVH gradually resolved. This report emphasizes the importance of routine measurement of blood pressure and describes the possible consequences of unrecognized arterial hypertension in children. Early diagnosis and appropriate treatment are necessary to avoid development and progression of target organ damage and promote better long-term cardiovascular prognosis.
authors: Department of Pediatrics I, Medical University Innsbruck, Innsbruck, Austria.
authors: Gerard
authors: G
authors: Cortina
authors: Johannes
authors: J
authors: Hofer
authors: Thomas
authors: T
authors: Giner
authors: Therese
authors: T
authors: Jungraithmayr
mesh_terms: D000293:Adolescent; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001766:Blindness / Q000209:etiology*; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006974:Hypertension, Malignant / Q000150:complications* / Q000188:drug therapy; D058437:Hypertensive Retinopathy / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D017379:Hypertrophy, Left Ventricular / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000601:surgery; D016030:Kidney Transplantation
chemical_list: D000959:Antihypertensive Agents
keywords: arterial hypertension; hypertensive retinopathy; left ventricular hypertrophy; target organ damage; vision loss