Reninoma: A Rare Cause of Endocrine Hypertension

Detalhes bibliográficos
Autor(a) principal: Marques, Bernardo
Data de Publicação: 2020
Outros Autores: Couto, Joana, Lemos, Manuel C., Rodrigues, Fernando
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660
Resumo: Juxtaglomerular tumours are rare causes of secondary hypertension. They typically present with difficult-to-manage hypertension, hypokalemia, hyperreninemia and secondary hyperaldosteronism. The authors describe a clinical case of a 45 years old female patient, with personal history of difficult-to-manage hypertension and hypokalemia since age 35, medicated with four types of anti-hypertensive agents. An analytical study was performed, which revealed secondary hyperaldosteronism [aldosterone 44.3 ng/dL (4 – 28 ng/dL), renin > 1000 mIU/mL (4.4 – 46.2 mIU/mL)]. Abdominal computed tomography scan identified a heterogeneous nodule located in the middle third of the right kidney, with 3.7 cm. Partial nephrectomy was performed and histological analysis confirmed the diagnosis of reninoma. After surgery, the patient had normal levels of aldosterone (9.2 ng/dL) and renin (1.20 mIU/mL), as well as normal blood pressure. The authors want to highlight this potentially curable cause of endocrine hypertension. Surgical resection is the treatment of choice and leads to normalization of blood pressure.
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spelling Reninoma: A Rare Cause of Endocrine HypertensionReninoma: Uma Causa Rara de Hipertensão EndócrinaAldosteroneHypertension/etiologyJuxtaglomerular ApparatusKidney NeoplasmsReninAldosteronaHipertensão/etiologiaNeoplasias do RimReninaSistema JustaglomerularJuxtaglomerular tumours are rare causes of secondary hypertension. They typically present with difficult-to-manage hypertension, hypokalemia, hyperreninemia and secondary hyperaldosteronism. The authors describe a clinical case of a 45 years old female patient, with personal history of difficult-to-manage hypertension and hypokalemia since age 35, medicated with four types of anti-hypertensive agents. An analytical study was performed, which revealed secondary hyperaldosteronism [aldosterone 44.3 ng/dL (4 – 28 ng/dL), renin > 1000 mIU/mL (4.4 – 46.2 mIU/mL)]. Abdominal computed tomography scan identified a heterogeneous nodule located in the middle third of the right kidney, with 3.7 cm. Partial nephrectomy was performed and histological analysis confirmed the diagnosis of reninoma. After surgery, the patient had normal levels of aldosterone (9.2 ng/dL) and renin (1.20 mIU/mL), as well as normal blood pressure. The authors want to highlight this potentially curable cause of endocrine hypertension. Surgical resection is the treatment of choice and leads to normalization of blood pressure.Os tumores justa-glomerulares são causas raras de hipertensão arterial de difícil controlo e cursam habitualmente com hipocaliémia, hiperreninémia e hiperaldosteronismo secundário. Descreve-se o caso de uma doente, de 45 anos, com história pessoal de hipertensão arterial de difícil controlo associada a hipocaliémia desde os 35 anos, medicada com quatro classes de anti-hipertensores. Do estudo realizado destaca-se hiperaldosteronismo secundário [aldosterona 44,3 ng/dL (4 - 28 ng/dL), renina > 1000 mUI/mL (4,4 - 46,16 mUI/mL)] e tomografia axial computorizada, que identificou formação nodular heterogénea localizada no terço médio do rim direito, com 3,7 cm de diâmetro. Foi realizada nefrectomia parcial, cuja análise histológica confirmou o diagnóstico de reninoma. Após a cirurgia, verificou-se normalização dos doseamentos hormonais (aldosterona 9,2 ng/dL; renina 1,20 mUI/mL) e da pressão arterial. Pretende-se chamar a atenção para esta causa potencialmente curável de hipertensão arterial endócrina. A ressecção cirúrgica é o tratamento de escolha e leva à normalização da pressão arterial.Ordem dos Médicos2020-12-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/pngimage/pngapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfimage/jpegimage/jpegimage/jpegimage/jpegapplication/mswordapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660oai:ojs.www.actamedicaportuguesa.com:article/11660Acta Médica Portuguesa; Vol. 33 No. 12 (2020): December; 835-838Acta Médica Portuguesa; Vol. 33 N.º 12 (2020): Dezembro; 835-8381646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660/5705https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660/10982https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660/10983https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660/10984https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660/10985https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660/10986https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660/10987https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660/10988https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660/10989https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660/11012https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660/11013https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660/11014https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660/11231https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660/11407https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11660/11422Direitos de Autor (c) 2019 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessMarques, BernardoCouto, JoanaLemos, Manuel C.Rodrigues, Fernando2022-12-20T11:06:18Zoai:ojs.www.actamedicaportuguesa.com:article/11660Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:04.217381Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Reninoma: A Rare Cause of Endocrine Hypertension
Reninoma: Uma Causa Rara de Hipertensão Endócrina
title Reninoma: A Rare Cause of Endocrine Hypertension
spellingShingle Reninoma: A Rare Cause of Endocrine Hypertension
Marques, Bernardo
Aldosterone
Hypertension/etiology
Juxtaglomerular Apparatus
Kidney Neoplasms
Renin
Aldosterona
Hipertensão/etiologia
Neoplasias do Rim
Renina
Sistema Justaglomerular
title_short Reninoma: A Rare Cause of Endocrine Hypertension
title_full Reninoma: A Rare Cause of Endocrine Hypertension
title_fullStr Reninoma: A Rare Cause of Endocrine Hypertension
title_full_unstemmed Reninoma: A Rare Cause of Endocrine Hypertension
title_sort Reninoma: A Rare Cause of Endocrine Hypertension
author Marques, Bernardo
author_facet Marques, Bernardo
Couto, Joana
Lemos, Manuel C.
Rodrigues, Fernando
author_role author
author2 Couto, Joana
Lemos, Manuel C.
Rodrigues, Fernando
author2_role author
author
author
dc.contributor.author.fl_str_mv Marques, Bernardo
Couto, Joana
Lemos, Manuel C.
Rodrigues, Fernando
dc.subject.por.fl_str_mv Aldosterone
Hypertension/etiology
Juxtaglomerular Apparatus
Kidney Neoplasms
Renin
Aldosterona
Hipertensão/etiologia
Neoplasias do Rim
Renina
Sistema Justaglomerular
topic Aldosterone
Hypertension/etiology
Juxtaglomerular Apparatus
Kidney Neoplasms
Renin
Aldosterona
Hipertensão/etiologia
Neoplasias do Rim
Renina
Sistema Justaglomerular
description Juxtaglomerular tumours are rare causes of secondary hypertension. They typically present with difficult-to-manage hypertension, hypokalemia, hyperreninemia and secondary hyperaldosteronism. The authors describe a clinical case of a 45 years old female patient, with personal history of difficult-to-manage hypertension and hypokalemia since age 35, medicated with four types of anti-hypertensive agents. An analytical study was performed, which revealed secondary hyperaldosteronism [aldosterone 44.3 ng/dL (4 – 28 ng/dL), renin > 1000 mIU/mL (4.4 – 46.2 mIU/mL)]. Abdominal computed tomography scan identified a heterogeneous nodule located in the middle third of the right kidney, with 3.7 cm. Partial nephrectomy was performed and histological analysis confirmed the diagnosis of reninoma. After surgery, the patient had normal levels of aldosterone (9.2 ng/dL) and renin (1.20 mIU/mL), as well as normal blood pressure. The authors want to highlight this potentially curable cause of endocrine hypertension. Surgical resection is the treatment of choice and leads to normalization of blood pressure.
publishDate 2020
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 33 No. 12 (2020): December; 835-838
Acta Médica Portuguesa; Vol. 33 N.º 12 (2020): Dezembro; 835-838
1646-0758
0870-399X
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