Hyponatremic hypertensive syndrome (HHS) in an 18-month old-child presenting as malignant hypertension: a case report
| dc.contributor.author | Dixit, Mehul | |
| dc.contributor.author | Hughes, John | |
| dc.contributor.author | Theodorou, Andreas | |
| dc.contributor.author | Dixit, Naznin | |
| dc.date.accessioned | 2016-05-20T08:57:43Z | |
| dc.date.available | 2016-05-20T08:57:43Z | |
| dc.date.issued | 2004 | en |
| dc.identifier.citation | BMC Nephrology 2004, 5:5 http://www.biomedcentral.com/1471-2369/5/5 | en |
| dc.identifier.doi | 10.1186/1471-2369-5-5 | en |
| dc.identifier.uri | http://hdl.handle.net/10150/610063 | |
| dc.description.abstract | BACKGROUND:The combination of hyponatremia and renovascular hypertension is called hyponatremic hypertensive syndrome (HHS). Malignant hypertension as a presentation has been reported in adults with HHS but is rare in children.CASE PRESENTATION:An eighteen month-old male presented with drowsiness, sudden onset status epilepticus and blood pressure of 210/160. The electrolytes on admission revealed sodium of 120 mEq/L and potassium of 2.1 mEq/L. The peripheral renin activity (PRA) was 172 ng/ml/min (normal 3-11 ng/ml/min) and serum aldosterone level was 91 ng/dl (normal 4 to 16 ng/dl). Patient underwent angioplasty with no success, followed by surgical correction. Two years since the diagnosis, the blood pressure is controlled with labetolol and amlodipine (at less than sixth of the pre-operative dosages). The PRA is 2.4 ng/ml/min and aldosterone 15.5 ng/dl. The child not only had three renal arteries on left but all of them were stenosed which to best of our knowledge has not been described.CONCLUSION:As uncommon as HHS with malignant hypertension may be in adults it is under-reported in children and purpose of the case report is to raise its awareness. | |
| dc.language.iso | en | en |
| dc.publisher | BioMed Central | en |
| dc.relation.url | http://www.biomedcentral.com/1471-2369/5/5 | en |
| dc.rights | © 2004 Dixit et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL. | en |
| dc.rights.uri | http://rightsstatements.org/vocab/InC/1.0/ | |
| dc.title | Hyponatremic hypertensive syndrome (HHS) in an 18-month old-child presenting as malignant hypertension: a case report | en |
| dc.type | Article | en |
| dc.identifier.eissn | 1471-2369 | en |
| dc.contributor.department | Steele Memorial Children's Research Center, Department of Pediatrics, University of Arizona, Tucson, USA | en |
| dc.contributor.department | Vascular Surgery, University of Arizona, Tucson, USA | en |
| dc.identifier.journal | BMC Nephrology | en |
| dc.description.collectioninformation | This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu. | en |
| dc.eprint.version | Final published version | en |
| refterms.dateFOA | 2018-07-14T01:12:39Z | |
| html.description.abstract | BACKGROUND:The combination of hyponatremia and renovascular hypertension is called hyponatremic hypertensive syndrome (HHS). Malignant hypertension as a presentation has been reported in adults with HHS but is rare in children.CASE PRESENTATION:An eighteen month-old male presented with drowsiness, sudden onset status epilepticus and blood pressure of 210/160. The electrolytes on admission revealed sodium of 120 mEq/L and potassium of 2.1 mEq/L. The peripheral renin activity (PRA) was 172 ng/ml/min (normal 3-11 ng/ml/min) and serum aldosterone level was 91 ng/dl (normal 4 to 16 ng/dl). Patient underwent angioplasty with no success, followed by surgical correction. Two years since the diagnosis, the blood pressure is controlled with labetolol and amlodipine (at less than sixth of the pre-operative dosages). The PRA is 2.4 ng/ml/min and aldosterone 15.5 ng/dl. The child not only had three renal arteries on left but all of them were stenosed which to best of our knowledge has not been described.CONCLUSION:As uncommon as HHS with malignant hypertension may be in adults it is under-reported in children and purpose of the case report is to raise its awareness. |
