Her headaches were initially treated symptomatically due to a positive family history of migraines. Other reported symptoms are nausea, polyuria with polydipsia, and fatigue We also discuss important points in the management of children presenting with renin-mediated hypertension. As a consequence of this hormonal activation, patients develop severe hypertension, potassium wasting, and hypokalemia. Most neoplastic cells are also diffusely positive for CD34 a vascular marker , an additional marker that can differentiate reninoma from RCC 8.
Abdominal ultrasonography did not reveal any abdominal masses and showed two structurally normal kidneys, with normal renal blood flows demonstrated by Doppler studies. Abstract Reninoma is a tumor of the renal juxtaglomerular cell apparatus that causes hypertension and hypokalemia via hypersecretion of renin. Complete resection of reninoma with an adequate rim of normal kidney tissue at least 0. The majority of these patients were children or adolescents. Surgical resection of reninoma nephron-sparing surgery is the treatment of choice and leads to normalization of blood pressure. As previously mentioned, kidney function was normal and there was no proteinuria or hematuria present. Our patient presented with hypokalemia and mild metabolic alkalosis.
Our patient presented with hypokalemia and mild metabolic alkalosis. Because of the normal appearance of the kidneys, we suspected a renovascular cause of hypertension. Physical examination on admission to hospital revealed a well-grown teenage girl.
Reninoma: case report and literature review.
Am J Kidney Dis 58 4: Due to the non-specific nature of presenting symptoms headaches and lethargy being the most commonthere is usually a delay in diagnosis of hypertension, sometimes by years. Reninoma juxtaglomerular cell tumor is a rare cause of renin-mediated hypertension.
In cases of suspected renin-mediated hypertension, the most physiological choice of antihypertensive treatment is the blockade of RAAS Although both retroperitoneal and transperitoneal minimal access routes have been described 2223we adopted the transperitoneal route in our patient because of a large experience with transperitoneal partial nephrectomy for adult renal tumors in our department.
In hypertensive patients presenting with hypokalemia and sometimes metabolic alkalosishigh caxe is the likely cause, guiding the investigations toward renal or adrenal causes of hypertension.
Reninoma: case report and literature review. – Semantic Scholar
We also discuss important points in the management of children presenting with renin-mediated hypertension. This means that you will not need to remember your user name and password in the future and you will be litterature to login with the account you choose to sync, with the click of a button.
Juxtaglomerular cell tumor in an 8-year-old girl. This can be done at multiple literahure of the axis by using renin inhibitors aliskirenACEI, angiotensin II receptor blockers ARBor aldosterone antagonists spironolactone, eplerenone. Kidney disease is the most common cause of secondary hypertension — one of the reasons why pediatric nephrologists are usually involved in the management of these children.
Increased production of renin from the affected kidneys causes blood pressure elevation, leading to the development of renin-mediated hypertension. Liteeature examination was normal.
Most neoplastic cells are also diffusely positive for CD34 a vascular markeran additional marker that can differentiate reninoma from RCC 8. We will be provided with an authorization token please note: R ratio of 3. In designing the optimal approach for our patient and her renin-secreting tumor, we appreciated the likely benign nature of this lesion Hypertension due to a renin-secreting renal tumour. Laparoscopic wedge resection of reninoma. As a particularly rare cause of hypertension, reninoma is seldom strongly considered in the imaging work-up in cases of pediatric hypertension.
They produce excessive amounts of renin, leading to secondary hyperaldosteronism. Computed tomographic angiography CTA excluded RAS, but revealed a rounded 10 mm diameter subcapsular mass under the surface of the litersture midpole of the left kidney Figure 1suggestive of reninoma. All authors were involved in the care of the patient. No chromosomal abnormalities were detected in our patient.
As an excellent means of imaging of the renal vasculature, renal parenchyma, and adrenal glands, we recommended that CTA be considered in all cases of renin-mediated hypertension in children.
Hypertensive target organ damage evaluation revealed normal magnetic resonance imaging MRI of the brain and structurally normal heart.
As a consequence of this hormonal activation, patients develop severe hypertension, potassium wasting, and hypokalemia. Both, the degree of hypokalemia and the amount of potassium excreted in urine, are influenced by the dietary intake of potassium.
Electron microscopy revealed renin deposits in the cytoplasm of the tumor cells, confirming the diagnosis of reninoma. Pubmed Abstract Pubmed Full Text.
Reninoma: Case report and literature review
Evaluation of retroperitoneoscopic partial nephrectomy with in situ geview perfusion. All tumor cells stained strongly for CD Enhanced imaging modalities and invasive renin sampling are helpful diagnostic tests leading to the correct diagnosis. The clue to clinical diagnosis is the presence of hypokalemia and metabolic alkalosis on the first blood sample drawn before any treatment is instituted.