Quando hipertensão arterial persistente no adolescente tem uma origem endócrina rara: relato de dois casos e revisão da literatura

Autores

  • Clara Gomes Centro Hospitalar Tondela-Viseu
  • Gabriela Laranjo Centro Hospitalar Tondela-Viseu
  • Elisabete Santos Centro Hospitalar Tondela-Viseu
  • Cristina Faria Centro Hospitalar Tondela-Viseu

DOI:

https://doi.org/10.15448/1980-6108.2017.3.26960

Palavras-chave:

adolescente, crianças, glândulas suprarrenais, catecolaminas, hipertensão, pressão arterial, feocromocitoma.

Resumo

*** Quando hipertensão arterial persistente no adolescente tem uma origem endócrina rara: relato de dois casos e revisão da literatura ***

OBJETIVOS: Relatar dois casos clínicos de feocromocitoma em adolescentes, um tumor raro na idade pediátrica, localizado na medula suprarrenal e maligno em até 47% dos casos, cuja clínica resulta da hipersecreção de catecolaminas.

DESCRIÇÃO DOS CASOS: Apresentam-se dois casos clínicos de feocromocitoma em adolescentes, ambos com hipertensão arterial persistente e um com cefaleia, sudorese e taquicardia. As ecografias renal e suprarrenal, a angio-tomografia e as dosagens de catecolaminas e seus metabolitos revelaram feocromocitoma da suprarrenal esquerda. Realizou-se adrenalectomia, após preparação farmacológica com α-bloqueadores. A anatomopatologia confirmou o diagnóstico. Ambos tiveram normalização dos valores da pressão arterial após o tratamento.

CONCLUSÕES: O feocromocitoma tem uma expressão clínica variável e inespecífica, devendo ser considerado no diagnóstico diferencial de hipertensão arterial. A sua detecção precoce poderá implicar um tratamento menos agressivo, menor morbilidade e menor impacto na qualidade de vida dos pacientes. A elevada probabilidade de recorrência, inclusive sob forma de metástases, implica em monitorização durante anos após a apresentação clínica inicial, mesmo no caso de cura aparente.

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Biografia do Autor

Clara Gomes, Centro Hospitalar Tondela-Viseu

Interna de Formação Específica de Pediatria

Gabriela Laranjo, Centro Hospitalar Tondela-Viseu

Assistente Hospitalar de Pediatria

Elisabete Santos, Centro Hospitalar Tondela-Viseu

Assistente Hospitalar de Pediatria

Cristina Faria, Centro Hospitalar Tondela-Viseu

Assistente Hospitalar Graduada de Pediatria

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2017-07-24

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Gomes, C., Laranjo, G., Santos, E., & Faria, C. (2017). Quando hipertensão arterial persistente no adolescente tem uma origem endócrina rara: relato de dois casos e revisão da literatura. Scientia Medica, 27(3), ID26960. https://doi.org/10.15448/1980-6108.2017.3.26960

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