When persistent hypertension in adolescents has a rare endocrine etiology: report of two cases and literature review

Clara Gomes, Gabriela Laranjo, Elisabete Santos, Cristina Faria

Abstract


*** When persistent hypertension  in adolescents has a rare endocrine etiology: report of two cases and literature review ***

AIMS: To report two clinical cases of pheochromocytoma, a rare tumor in the pediatric population, that affects the adrenal medulla, is malignant in up to 47% of cases,  and whose clinical manifestations result from hypersecretion of catecholamines.

CASE DESCRIPTION: Two cases of pheochromocytoma in adolescents are described, both with persistent hypertension and one with headache, sweating, and tachycardia. Renal and adrenal ultrasound, computed tomography angiography, and measurements of catecholamines and their metabolites revealed pheochromocytoma in the left adrenal gland. Adrenalectomy was performed after pretreatment with α-blockers. Pathological examination confirmed the diagnosis. Blood pressure returned to normal in both patients after treatment.

CONCLUSIONS: Pheochromocytoma has a varied and nonspecific clinical presentation, but this condition should always be considered in the differential diagnosis of high blood pressure. Early diagnosis may imply a less aggressive treatment, lower morbidity, and a lesser impact on patients’ quality of life. The high likelihood of recurrence of pheochromocytoma, including as metastatic disease, requires follow-up visits for several years after its initial clinical presentation, even in the case of an apparent cure.


Keywords


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

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DOI: http://dx.doi.org/10.15448/1980-6108.2017.3.26960

 

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