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

Detalhes bibliográficos
Autor(a) principal: Gomes, Clara
Data de Publicação: 2017
Outros Autores: Laranjo, Gabriela, Santos, Elisabete, Faria, Cristina
Tipo de documento: Artigo
Idioma: por
Título da fonte: Scientia Medica (Porto Alegre. Online)
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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spelling 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
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
title_full_unstemmed 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
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
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