When persistent hypertension in adolescents has a rare endocrine etiology: report of two cases and literature review
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Scientia Medica (Porto Alegre. Online) |
DOI: | 10.15448/1980-6108.2017.3.26960 |
Texto Completo: | https://revistaseletronicas.pucrs.br/scientiamedica/article/view/26960 |
Resumo: | *** 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. |
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Scientia Medica (Porto Alegre. Online) |
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When persistent hypertension in adolescents has a rare endocrine etiology: report of two cases and literature reviewQuando hipertensão arterial persistente no adolescente tem uma origem endócrina rara: relato de dois casos e revisão da literaturaadolescentecriançasglândulas suprarrenaiscatecolaminashipertensãopressão arterialfeocromocitoma.*** 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.*** 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.Editora da PUCRS - ediPUCRS2017-07-24info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionRelato de caso raro ou de especial interesseapplication/pdfhttps://revistaseletronicas.pucrs.br/scientiamedica/article/view/2696010.15448/1980-6108.2017.3.26960Scientia Medica; Vol. 27 No. 3 (2017); ID26960Scientia Medica; v. 27 n. 3 (2017); ID269601980-61081806-556210.15448/1980-6108.2017.3reponame:Scientia Medica (Porto Alegre. Online)instname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSporhttps://revistaseletronicas.pucrs.br/scientiamedica/article/view/26960/15775Copyright (c) 2017 Scientia Medicainfo:eu-repo/semantics/openAccessGomes, ClaraLaranjo, GabrielaSantos, ElisabeteFaria, Cristina2017-08-28T14:46:54Zoai:ojs.revistaseletronicas.pucrs.br:article/26960Revistahttps://revistaseletronicas.pucrs.br/scientiamedica/PUBhttps://revistaseletronicas.pucrs.br/scientiamedica/oaiscientiamedica@pucrs.br || editora.periodicos@pucrs.br1980-61081806-5562opendoar:2017-08-28T14:46:54Scientia Medica (Porto Alegre. Online) - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.none.fl_str_mv |
When persistent hypertension in adolescents has a rare endocrine etiology: report of two cases and literature review Quando hipertensão arterial persistente no adolescente tem uma origem endócrina rara: relato de dois casos e revisão da literatura |
title |
When persistent hypertension in adolescents has a rare endocrine etiology: report of two cases and literature review |
spellingShingle |
When persistent hypertension in adolescents has a rare endocrine etiology: report of two cases and literature review When persistent hypertension in adolescents has a rare endocrine etiology: report of two cases and literature review Gomes, Clara adolescente crianças glândulas suprarrenais catecolaminas hipertensão pressão arterial feocromocitoma. Gomes, Clara adolescente crianças glândulas suprarrenais catecolaminas hipertensão pressão arterial feocromocitoma. |
title_short |
When persistent hypertension in adolescents has a rare endocrine etiology: report of two cases and literature review |
title_full |
When persistent hypertension in adolescents has a rare endocrine etiology: report of two cases and literature review |
title_fullStr |
When persistent hypertension in adolescents has a rare endocrine etiology: report of two cases and literature review When persistent hypertension in adolescents has a rare endocrine etiology: report of two cases and literature review |
title_full_unstemmed |
When persistent hypertension in adolescents has a rare endocrine etiology: report of two cases and literature review When persistent hypertension in adolescents has a rare endocrine etiology: report of two cases and literature review |
title_sort |
When persistent hypertension in adolescents has a rare endocrine etiology: report of two cases and literature review |
author |
Gomes, Clara |
author_facet |
Gomes, Clara Gomes, Clara Laranjo, Gabriela Santos, Elisabete Faria, Cristina Laranjo, Gabriela Santos, Elisabete Faria, Cristina |
author_role |
author |
author2 |
Laranjo, Gabriela Santos, Elisabete Faria, Cristina |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Gomes, Clara Laranjo, Gabriela Santos, Elisabete Faria, Cristina |
dc.subject.por.fl_str_mv |
adolescente crianças glândulas suprarrenais catecolaminas hipertensão pressão arterial feocromocitoma. |
topic |
adolescente crianças glândulas suprarrenais catecolaminas hipertensão pressão arterial feocromocitoma. |
description |
*** 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. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-07-24 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Relato de caso raro ou de especial interesse |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://revistaseletronicas.pucrs.br/scientiamedica/article/view/26960 10.15448/1980-6108.2017.3.26960 |
url |
https://revistaseletronicas.pucrs.br/scientiamedica/article/view/26960 |
identifier_str_mv |
10.15448/1980-6108.2017.3.26960 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revistaseletronicas.pucrs.br/scientiamedica/article/view/26960/15775 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Scientia Medica info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Scientia Medica |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Editora da PUCRS - ediPUCRS |
publisher.none.fl_str_mv |
Editora da PUCRS - ediPUCRS |
dc.source.none.fl_str_mv |
Scientia Medica; Vol. 27 No. 3 (2017); ID26960 Scientia Medica; v. 27 n. 3 (2017); ID26960 1980-6108 1806-5562 10.15448/1980-6108.2017.3 reponame:Scientia Medica (Porto Alegre. Online) instname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) instacron:PUC_RS |
instname_str |
Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) |
instacron_str |
PUC_RS |
institution |
PUC_RS |
reponame_str |
Scientia Medica (Porto Alegre. Online) |
collection |
Scientia Medica (Porto Alegre. Online) |
repository.name.fl_str_mv |
Scientia Medica (Porto Alegre. Online) - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) |
repository.mail.fl_str_mv |
scientiamedica@pucrs.br || editora.periodicos@pucrs.br |
_version_ |
1822181830402506752 |
dc.identifier.doi.none.fl_str_mv |
10.15448/1980-6108.2017.3.26960 |