Refractory hypertension caused by renal artery fibromuscular dysplasia in one child
10.3969/j.issn.1000-3606.2019.01.013
- VernacularTitle:儿童肾动脉纤维肌发育不良致难治性高血压1例报告
- Author:
Naiqing CHEN
1
;
Huijie XIAO
;
Fang WANG
Author Information
1. 北京大学第一医院
- Keywords:
renal vascular hypertension;
renin-angiotensin-aldosterone;
renal artery fibromuscular dysplasia;
child
- From:
Journal of Clinical Pediatrics
2019;37(1):51-54
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical characteristics, diagnosis and treatment of refractory hypertension caused by renal artery fibromuscular dysplasia (FMD) in children. Method The clinical data of a child with refractory hypertension caused by FMD were retrospectively analyzed. Results A boy, with onset at age of 4 years, had significantly increased blood pressure and decreased serum potassium. His renin and angiotensin levels were significantly elevated. The boy was diagnosed with renovascular hypertension by color Doppler ultrasonography, enhanced thoracoabdominal CT and vascular reconstruction. Oral administration of a variety of antihypertensive drugs is not effective. The child was finally diagnosed of refractory hypertension caused by FMD using renal angiography. The child was not suitable for surgery. After adjusting the antihypertensive drugs, the blood pressure of the child tended to be stable. The boy received continuous follow-up for 8 years. The antihypertensive regimen was adjusted annually and blood pressure fluctuations and target organ damage were dynamically assessed. Conclusion Children with FMD caused renal vascular hypertension may have no specific manifestations in the early stage. The drug treatment is preferred, and surgical treatment may be considered.
