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Open Access 01-11-2009 | Educational Feature

At the bottom of the differential diagnosis list: unusual causes of pediatric hypertension

Authors: Matthew M. Grinsell, Victoria F. Norwood

Published in: Pediatric Nephrology | Issue 11/2009

Abstract

Hypertension affects 1–5% of children and adolescents, and the incidence has been increasing in association with obesity. However, secondary causes of hypertension such as renal parenchymal diseases, congenital abnormalities and renovascular disorders still remain the leading cause of pediatric hypertension, particularly in children under 12 years old. Other less common causes of hypertension in children and adolescents, including immobilization, burns, illicit and prescription drugs, dietary supplements, genetic disorders, and tumors will be addressed in this review.

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Norwood VF (2002) Hypertension. Pediatr Rev 23:197–208PubMed

Wyszynska T, Cichocka E, Wieteska-Klimczak A, Jobs K, Januszewicz P (1992) A single pediatric center experience with 1025 children with hypertension. Acta Paediatr 81:244–246PubMed

Heij HA, Ekkelkamp S, Vos A (1992) Hypertension associated with skeletal traction in children. Eur J Pediatr 151:543–545PubMed

Andrews PI, Rosenberg AR (1990) Renal consequences of immobilisation in children with fractured femurs. Acta Paediatr Scand 79:311–315PubMed

Hamdan JA, Taleb YA, Ahmed MS (1984) Traction-induced hypertension in children. Clin Orthop Relat Res 185:87–89

Linshaw MA, Stapleton FB, Gruskin AB, Baluarte HJ, Harbin GL (1979) Traction-related hypertension in children. J Pediatr 95:994–996PubMed

Turner MC, Ruley EJ, Buckley KM, Strife CF (1979) Blood pressure elevation in children with orthopedic immobilization. J Pediatr 95:989–992PubMed

Welner A, Yosipovitch ZH, Groen JJ (1966) Elevated blood pressure in children and adolescents with residual paralysis and deformities from poliomyelitis and other crippling diseases. J Chronic Dis 19:1157–1164PubMed

Conley SB, Shackelford GD, Robson AM (1979) Severe immobilization hypercalcemia, renal insufficiency, and calcification. Pediatrics 63:142–145PubMed

10.

Little JA, Dean AE Jr, Chapman M (1982) Immobilization hypercalcemia. South Med J 75:502PubMed

11.

Henke JA, Thompson NW, Kaufer H (1975) Immobilization hypercalcemia crisis. Arch Surg 110:321–323PubMed

12.

Donaldson CL, Hulley SB, Vogel JM, Hattner RS, Bayers JH, McMillan DE (1970) Effect of prolonged bed rest on bone mineral. Metabolism 19:1071–1084PubMed

13.

Gallacher SJ, Ralston SH, Dryburgh FJ, Dryburgh FJ, Logue FC, Allam BF, Boyce BF, Boyle IT (1990) Immobilization-related hypercalcaemia-a possible novel mechanism and response to pamidronate. Postgrad Med J 66:918–922PubMedPubMedCentral

14.

Heath H 3rd, Earll JM, Schaaf M, Piechocki JT, Li TK (1972) Serum ionized calcium during bed rest in fracture patients and normal men. Metabolism 21:633–640PubMed

15.

Hyman LR, Boner G, Thomas JC, Segar WE (1972) Immobilization hypercalcemia. Am J Dis Child 124:723–727PubMed

16.

Rosen JF, Wolin DA, Finberg L (1978) Immobilization hypercalcemia after single limb fractures in children and adolescents. Am J Dis Child 132:560–564PubMed

17.

Stewart AF, Adler M, Byers CM, Segre GV, Broadus AE (1982) Calcium homeostasis in immobilization: an example of resorptive hypercalciuria. N Engl J Med 306:1136–1140PubMed

18.

Ellison DH, Shneidman R, Morris C, McCarron DA (1986) Effects of calcium infusion on blood pressure in hypertensive and normotensive humans. Hypertension 8:497–505PubMed

19.

Suzuki T, Aoki K (1988) Hypertensive effects of calcium infusion in subjects with normotension and hypertension. J Hypertens 6:1003–1008PubMed

20.

Berliner BC, Shenker IR, Weinstock MS (1972) Hypercalcemia associated with hypertension due to prolonged immobilization. (An unusual complication of extensive burns.) Pediatrics 49:92–96PubMed

21.

Meythaler JM, Tuel SM, Cross LL (1993) Successful treatment of immobilization hypercalcemia using calcitonin and etidronate. Arch Phys Med Rehabil 74:316–319PubMed

22.

McIntyre HD, Cameron DP, Urquhart SM, Davies WE (1989) Immobilization hypercalcaemia responding to intravenous pamidronate sodium therapy. Postgrad Med J 65:244–246PubMedPubMedCentral

23.

Yosipovitch ZH, Palti Y (1967) Alterations in blood pressure during leg-lengthening. A clinical and experimental investigation. J Bone Joint Surg Am 49:1352–1358PubMed

24.

Harandi BA, Zahir A (1974) Severe hypertension following correction of flexion contracture of the knee. A report of two cases. J Bone Joint Surg Am 56:1733–1734PubMed

25.

Husmann DA, McLorie GA, Churchill BM (1993) Hypertension following primary bladder closure for vesical exstrophy. J Pediatr Surg 28:239–241PubMed

26.

Bass DH, Semple PL, Cywes S (1991) Investigation and management of blunt renal injuries in children: a review of 11 years’ experience. J Pediatr Surg 26:196–200PubMed

27.

Cass AS (1983) Blunt renal trauma in children. J Trauma 23:123–127PubMed

28.

Jameson RM (1973) Transient hypertension associated with closed renal injury. Br J Urol 45:482–484PubMed

29.

Monstrey SJ, Beerthuizen GI, vander Werken C, Debruyne FM, Goris RJ (1989) Renal trauma and hypertension. J Trauma 29:65–70PubMed

30.

Dark P, Woodford M, Vail A, Mackway-Jones K, Yates D, Lecky F (2002) Systolic hypertension and the response to blunt trauma in infants and children. Resuscitation 54:245–253PubMed

31.

Montgomery RC, Richardson JD, Harty JI (1998) Posttraumatic renovascular hypertension after occult renal injury. J Trauma 45:106–110PubMed

32.

Seruca H, DeBock J, Guttman FM (1979) Renal trauma in children. Can J Surg 22:24–25PubMed

33.

Grant RP Jr, Gifford RW Jr, Pudvan WR, Meaney TF, Straffon RA, McCormack LJ (1971) Renal trauma and hypertension. Am J Cardiol 27:173–176PubMed

34.

Chedid A, Le Coz S, Rossignol P, Bobrie G, Herpin D, Plouin PF (2006) Blunt renal trauma-induced hypertension: prevalence, presentation, and outcome. Am J Hypertens 19:500–504PubMed

35.

Maling TJ, Little PJ, Maling TM, Gunesekera M, Bailey RR (1976) Renal trauma and persistent hypertension. Nephron 16:173–180PubMed

36.

Hutchison RJ, Nogrady MB (1973) Late sequelae of renal trauma in the pediatric age group. J Can Assoc Radiol 24:3–11PubMed

37.

Surana R, Khan A, Fitzgerald RJ (1995) Scarring following renal trauma in children. Br J Urol 75:663–665PubMed

38.

Barsness KA, Bensard DD, Partrick D, Hendrickson R, Koyle M, Calkins CM, Karrer F (2004) Renovascular injury: an argument for renal preservation. J Trauma 57:310–315PubMed

39.

Margenthaler JA, Weber TR, Keller MS (2002) Blunt renal trauma in children: experience with conservative management at a pediatric trauma center. J Trauma 52:928–932PubMed

40.

Nance ML, Lutz N, Carr MC, Canning DA, Stafford PW (2004) Blunt renal injuries in children can be managed nonoperatively: outcome in a consecutive series of patients. J Trauma 57:474–478PubMed

41.

Falkner B, Roven S, DeClement FA, Bendlin A (1978) Hypertension in children with burns. J Trauma 8:213–217

42.

Popp MB, Friedberg DL, MacMillan BG (1980) Clinical characteristics of hypertension in burned children. Ann Surg 191:473–478PubMedPubMedCentral

43.

Popp MB, Silberstein EB, Srivastava LS, Loggie JM, Knowles HC Jr, MacMillan BG (1981) A pathophysiologic study of the hypertension associated with burn injury in children. Ann Surg 193:817–824PubMedPubMedCentral

44.

Cachat F, Van Melle G, McGahren ED, Reinberg O, Norwood V (2006) Arterial hypertension after surgical closure of omphalocele and gastroschisis. Pediatr Nephrol 21:225–229PubMed

45.

DeLuca FG, Gilchrist BF, Paquette E, Wesselhoeft CW, Luks FI (1996) External compression as initial management of giant omphaloceles. J Pediatr Surg 31:965–967PubMed

46.

National Institute on Drug Abuse (2006) Crack and cocaine. Accessed at http://www.nida.nih.gov/infofacts/cocaine.html

47.

Lange RA, Hillis LD (2001) Cardiovascular complications of cocaine use. N Engl J Med 345:351–358PubMed

48.

Frishman WH, Del Vecchio A, Sanal S, Ismail A (2003) Cardiovascular manifestations of substance abuse: part 2: alcohol, amphetamines, heroin, cannabis, and caffeine. Heart Dis 5:253–271PubMed

49.

Mo W, Arruda JA, Dunea G, Singh AK (1999) Cocaine-induced hypertension: role of the peripheral sympathetic system. Pharmacol Res 40:139–145PubMed

50.

Mo W, Singh AK, Arruda JA, Dunea G (1998) Role of nitric oxide in cocaine-induced acute hypertension. Am J Hypertens 11:708–714PubMed

51.

National Institute on Drug Abuse (2004) Cocaine abuse and addiction. Accessed at http://www.drugabuse.gov/ResearchReports/Cocaine/Cocaine.html

52.

National Institute on Drug Abuse (2006) Methamphetamine abuse and addiction. Accessed at http://www.drugabuse.gov/ResearchReports/Methamph/Methamph.html

53.

Doyon S (2001) The many faces of ecstasy. Curr Opin Pediatr 13:170–176PubMed

54.

Johnson BA, Wells LT, Roache JD, Wallace C, Ait-Daoud N, Wang Y (2005) Isradipine decreases the hemodynamic response of cocaine and methamphetamine results from two human laboratory studies: results from two human laboratory studies. Am J Hypertens 18:813–822PubMed

55.

McGee SM, McGee DN, McGee MB (2004) Spontaneous intracerebral hemorrhage related to methamphetamine abuse: autopsy findings and clinical correlation. Am J Forensic Med Pathol 25:334–337PubMed

56.

National Institute on Drug Abuse (2005) Prescription drugs abuse and addiction. Accessed at http://www.drugabuse.gov/ResearchReports/Prescription/Prescription.html

57.

Friedman RA (2006) The changing face of teenage drug abuse-the trend toward prescription drugs. N Engl J Med 354:1448–1450PubMed

58.

Ball SD, Kertesz D, Moyer-Mileur LJ (2005) Dietary supplement use is prevalent among children with a chronic illness. J Am Diet Assoc 105:78–84PubMed

59.

Losier A, Taylor B, Fernandez CV (2005) Use of alternative therapies by patients presenting to a pediatric emergency department. J Emerg Med 28:267–271PubMed

60.

Isnard Bagnis C, Deray G, Baumelou A, Le Quintrec M, Vanherweghem JL (2004) Herbs and the kidney. Am J Kidney Dis 44:1–11PubMed

61.

Snodgrass W (2001) Herbal products: Risks and benefits for use in children. Curr Ther Res Clin Exp 62:724–737

62.

Tomassoni AJ, Simone K (2001) Herbal medicines for children: an illusion of safety? Curr Opin Pediatr 13:162–169PubMed

63.

Haller CA, Benowitz NL (2000) Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 343:1833–1838PubMed

64.

Valli G, Giardina EG (2002) Benefits, adverse effects and drug interactions of herbal therapies with cardiovascular effects. J Am Coll Cardiol 39:1083–1095PubMed

65.

Licorice Root: Glycyrrhiza glabra (2006) Accessed 2007, at http://nccam.nih.gov/health/licoriceroot/

66.

de Klerk GJ, Nieuwenhuis MG, Beutler JJ (1997) Hypokalaemia and hypertension associated with use of liquorice flavoured chewing gum. BMJ 314:731–732PubMedPubMedCentral

67.

Quinkler M, Stewart PM (2003) Hypertension and the cortisol-cortisone shuttle. J Clin Endocrinol Metab 88:2384–2392PubMed

68.

Whorwood CB, Sheppard MC, Stewart PM (1993) Licorice inhibits 11 beta-hydroxysteroid dehydrogenase messenger ribonucleic acid levels and potentiates glucocorticoid hormone action. Endocrinology 132:2287–2292PubMed

69.

Beretta-Piccoli C, Salvade G, Crivelli PL, Weidmann P (1985) Body-sodium and blood volume in a patient with licorice-induced hypertension. J Hypertens 3:19–23PubMed

70.

Quaschning T, Ruschitzka F, Shaw S, Luscher TF (2001) Aldosterone receptor antagonism normalizes vascular function in liquorice-induced hypertension. Hypertension 37:801–805PubMed

71.

Ewart AK, Morris CA, Atkinson D, Jin W, Sternes K, Spallone P, Stock AD, Leppert M, Keating MT (1993) Hemizygosity at the elastin locus in a developmental disorder, Williams syndrome. Nat Genet 5:11–16PubMed

72.

O’Connor WN, Davis JB Jr, Geissler R, Cottrill CM, Noonan JA, Todd EP (1985) Supravalvular aortic stenosis. Clinical and pathologic observations in six patients. Arch Pathol Lab Med 109:179–185PubMed

73.

Del Campo M, Antonell A, Magano LF, Muñoz FJ, Flores R, Bayés M, Pérez Jurado LA (2006) Hemizygosity at the NCF1 gene in patients with Williams-Beuren syndrome decreases their risk of hypertension. Am J Hum Genet 78:533–542PubMedPubMedCentral

74.

Giordano U, Turchetta A, Giannotti A, Digilio MC, Virgilii F, Calzolari A (2001) Exercise testing and 24-hour ambulatory blood pressure monitoring in children with Williams syndrome. Pediatr Cardiol 22:509–511PubMed

75.

Salaymeh KJ, Banerjee A (2001) Evaluation of arterial stiffness in children with Williams syndrome: Does it play a role in evolving hypertension? Am Heart J 142:549–555PubMed

76.

Crino PB, Nathanson KL, Henske EP (2006) The tuberous sclerosis complex. N Engl J Med 355:1345–1356

77.

Brook-Carter PT, Peral B, Ward CJ, Thompson P, Hughes J, Maheshwar MM, Nellist M, Gamble V, Harris PC, Sampson JR (1994) Deletion of the TSC2 and PKD1 genes associated with severe infantile polycystic kidney disease-a contiguous gene syndrome. Nat Genet 8:328–332PubMed

78.

Laass MW, Spiegel M, Jauch A, Hahn G, Rupprecht E, Vogelberg C, Bartsch O, Huebner A (2004) Tuberous sclerosis and polycystic kidney disease in a 3-month-old infant. Pediatr Nephrol 19:602–608PubMed

79.

Wong H, Hadi M, Khoury T, Geary D, Rubin B, Filler G (2006) Management of severe hypertension in a child with tuberous sclerosis-related major vascular abnormalities. J Hypertens 24:597–599PubMed

80.

Friedman JM, Arbiser J, Epstein JA, Gutmann DH, Huot SJ, Lin AE, McManus B, Korf BR (2002) Cardiovascular disease in neurofibromatosis 1: report of the NF1 Cardiovascular Task Force. Genet Med 4:105–111PubMed

81.

Fossali E, Signorini E, Intermite RC, Casalini E, Lovaria A, Maninetti MM, Rossi LN (2000) Renovascular disease and hypertension in children with neurofibromatosis. Pediatr Nephrol 14:806–810PubMed

82.

Lama G, Graziano L, Calabrese E, Grassia C, Rambaldi PF, Cioce F, Tedesco MA, Di Salvo G, Esposito-Salsano M (2004) Blood pressure and cardiovascular involvement in children with neurofibromatosis type1. Pediatr Nephrol 19:413–418PubMed

83.

Courtel JV, Soto B, Niaudet P, Gagnadoux MF, Carteret M, Quignodon JF, Brunelle F (1998) Percutaneous transluminal angioplasty of renal artery stenosis in children. Pediatr Radiol 28:59–63PubMed

84.

Zderic SA (2004) Renal and adrenal tumors in children. Urol Clin North Am 31:607–617, xiPubMed

85.

Barontini M, Levin G, Sanso G (2006) Characteristics of pheochromocytoma in a 4- to 20-year-old population. Ann N Y Acad Sci 1073:30–37PubMed

86.

Hering A, Guratowska M, Bucsky P, Claussen U, Decker J, Ernst G, Hoeppner W, Michel S, Neumann H, Parlowsky T, Loncarevic I (2006) Characteristic genomic imbalances in pediatric pheochromocytoma. Genes Chromosomes Cancer 45:602–607PubMed

87.

Weise M, Merke DP, Pacak K, Walther MM, Eisenhofer G (2002) Utility of plasma free metanephrines for detecting childhood pheochromocytoma. J Clin Endocrinol Metab 87:1955–1960PubMed

88.

Kohane DS, Ingelfinger JR, Nimkin K, Wu CL (2005) Case records of the Massachusetts General Hospital. Case 16–2005. A nine-year-old girl with headaches and hypertension. N Engl J Med 352:2223–2231PubMed

89.

Chambo JL, Falci Junior R, Lucon AM (2004) Juxtaglomerular cell tumor as a rare cause of hypertension in adults. Int Braz J Urol 30:119–120PubMed

90.

Markey RB, MacLennan GT (2006) Juxtaglomerular cell tumor of the kidney. J Urol 175:730PubMed

91.

Martin SA, Mynderse LA, Lager DJ, Cheville JC (2001) Juxtaglomerular cell tumor: a clinicopathologic study of four cases and review of the literature. Am J Clin Pathol 116:854–863PubMed

92.

McVicar M, Carman C, Chandra M, Abbi RJ, Teichberg S, Kahn E (1993) Hypertension secondary to renin-secreting juxtaglomerular cell tumor: case report and review of 38 cases. Pediatr Nephrol 7:404–412PubMed

93.

Robertson PW, Klidjian A, Harding LK, Walters G, Lee MR, Robb-Smith AH (1967) Hypertension due to a renin-secreting renal tumour. Am J Med 43:963–976PubMed

Title: At the bottom of the differential diagnosis list: unusual causes of pediatric hypertension
Authors: Matthew M. Grinsell
Victoria F. Norwood
Publication date: 01-11-2009
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 11/2009
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-008-0744-y

At a glance: The STEP trials

Springer Medicine

At the bottom of the differential diagnosis list: unusual causes of pediatric hypertension

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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