Renovascular hypertension: a case with atypical neurological signs.
Secondary hypertension is the most frequent form of hypertension in children. Renovascular disease accounts for 5-10% of all childhood hypertension and should be suspected in the presence of severe hypertension found difficult to manage with medical therapy. Uncontrolled hypertension can lead to severe target organ damage. We describe the case of a 13-month-old baby boy with failure to thrive, recent muscular weakness of the lower extremities and irritability. Hypertension was detected and he was admitted to the paediatric intensive care unit with a refractory hypertensive emergency, despite multiple antihypertensive therapies. Bilateral renal artery stenosis was diagnosed through renal angiography and balloon dilation was performed, leading to lower blood pressure. He is currently withdrawing from antihypertensive medication, and slowly gaining weight and recovering from target organ damage. However, weakness of the lower extremities persists and he has been diagnosed with a neurogenic bladder.
Hospital Pediátrico de Coimbra, Coimbra, Portugal.
Mónica
M
Jerónimo
Pediatric Intensive Care Unit, Hospital Pediátrico de Coimbra, Coimbra, Portugal.
Teresa
T
Dionísio
Department of Paediatric Nephrology, Hospital Pediátrico de Coimbra, Coimbra, Portugal.
Clara
C
Gomes
Pediatric Intensive Care Unit, Hospital Pediátrico de Coimbra, Coimbra, Portugal.
José Farela
JF
Neves
D000792:Angiography; D000800:Angioplasty, Balloon / Q000379:methods*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D007223:Infant; D008297:Male; D012077:Renal Artery / Q000473:pathology*; D012078:Renal Artery Obstruction / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis*
D000959:Antihypertensive Agents