RESUMO
Malignant hypertension is a well-defined condition associated with high blood pressure and acute target-organ damage. Although 95% of cases are secondary to essential hypertension, its etiological profile is broad. Juxtaglomerular cell tumor is a rare condition, with only approximately 65 cases reported to date. We describe a patient with malignant hypertension with acute renal failure and intestinal ischemia secondary to a juxtaglomerular cell tumor. We believe this is the first case of juxtaglomerular cell tumor causing malignant hypertension. The diagnostic approach and treatment are discussed.
Assuntos
Adenocarcinoma/complicações , Hipertensão Maligna/etiologia , Intestinos/irrigação sanguínea , Isquemia/etiologia , Sistema Justaglomerular/metabolismo , Neoplasias Renais/complicações , Renina/metabolismo , Abdome Agudo/etiologia , Injúria Renal Aguda/etiologia , Adenocarcinoma/diagnóstico , Adenocarcinoma/metabolismo , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Adulto , Anlodipino/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Terapia Combinada , Feminino , Transtornos da Cefaleia/etiologia , Humanos , Hipertensão Maligna/tratamento farmacológico , Hipertensão Maligna/cirurgia , Hipertrofia Ventricular Esquerda/etiologia , Intestinos/patologia , Neoplasias Renais/diagnóstico , Neoplasias Renais/metabolismo , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Necrose , Nefrectomia , Papiledema/etiologia , Gravidez , Complicações na Gravidez/etiologia , Hemorragia Retiniana/etiologiaRESUMO
We report a secretory paraganglioma in an eleven-year-old Trinidadian girl of East Indian descent who presented with malignant hypertension, proteinuria and modest elevation of urinary vanillylmandelic acid levels. The extra-adrenal mass was surgically removed without complications. The patient has been normotensive without evidence of recurrence of disease but with persistent visual sequel two years later. This case reinforces the observation that extraadrenal retroperitoneal paragangliomas can be functionally very active and early computed tomography or other imaging procedure is necessary for rapid noninvasive evaluation, timely surgery and prevention of permanent morbidity.
Assuntos
Hipertensão Maligna/etiologia , Paraganglioma/complicações , Neoplasias Retroperitoneais/complicações , Transtornos da Visão/etiologia , Criança , Feminino , Humanos , Hipertensão Maligna/cirurgia , Paraganglioma/cirurgia , Neoplasias Retroperitoneais/cirurgia , Ácido Vanilmandélico/urina , Acuidade VisualRESUMO
We report a secretory paraganglioma in an eleven-year-old Trinidadian girl of East Indian descent who presented with malignant hypertension, proteinuria and modest elevation of urinary vanillylmandelic acid levels. The extraadrenal mass was surgically removed without complications. The patient has been normotensive without evidence of recurrence of disease but with persistent visual sequel two years later. This case reinforces the observation that extraadrenal retroperitoneal paragangliomas can be functionally very active and early computed tomography or other imaging procedure is necessary for rapid noninvasive evaluation, timely surgery and prevention of permanent morbidity.
Assuntos
Criança , Feminino , Humanos , Paraganglioma/complicações , Neoplasias Retroperitoneais/complicações , Transtornos da Visão/etiologia , Hipertensão Maligna/etiologia , Paraganglioma/cirurgia , Neoplasias Retroperitoneais/cirurgia , Trinidad e Tobago , Ácido Vanilmandélico/urina , Acuidade Visual , Hipertensão Maligna/cirurgiaRESUMO
We report a secretory paraganglioma in an eleven-year-old Trinidadian girl of East Indian descent who presented with malignant hypertension, proteinuria and modest elevation of urinary vanillylmandelic acid levels. The extraadrenal mass was surgically removed without complications. The patient has been normotensive without evidence of recurrence of disease but with persistent visual sequel two years later. This case reinforces the observation that extraadrenal retroperitoneal paragangliomas can be functionally very active and early computed tomography or other imaging procedure is necessary for rapid noninvasive evaluation, timely surgery and prevention of permanent morbidity.(Au)
Assuntos
Criança , Relatos de Casos , Feminino , Humanos , Paraganglioma/complicações , Hipertensão Maligna/etiologia , Neoplasias Retroperitoneais/complicações , Transtornos da Visão/etiologia , Trinidad e Tobago , Hipertensão Maligna/cirurgia , Paraganglioma/cirurgia , Neoplasias Retroperitoneais/cirurgia , Ácido Vanilmandélico/urina , Acuidade VisualRESUMO
Os autores apresentam o caso de um paciente de 35 anos portador de hipertensäo arterial maligna, decorrente de estenose severa da artéria renal esquerda. Houve cura completa com a cirurgia de revascularizaçäo (ponte de safena). Tecem consieraçöes a respeito de conduta, controvérsias e diagnóstico diferencial desta enfermidade