A rare endocrine cause of hypertension in children
11 till 15 October 2012، Tehran - Iran
Presentation Type: Speech
Pheochromocytomas and paragangliomas are rare neoplasms in children. Tumors that arise from the adrenal medulla are termed pheochromocytomas, and those with extra-adrenal origins are called paragangliomas. Among hypertensive children, the incidence of surgically confirmed disease has ranged from 0.8 to 1.7 percent. Because of the uncommon nature of the disease, there have been few published reports of pheochromocytoma in children. Given the limited experiences with this disease in children and the similarity in clinical presentation, diagnosis, and treatment among children, the following report includes some data derived from a patient with pheochromocytoma. Case Presentation: A 13 year old boy, 8th child of the family referred to us with right upper quadrant abdominal pain, palpitation, pallor in morning, increased appetite, perspiration, headache and irritability for 1 month before the visit. In physical examamination, he had warm and wet skin, high pulse rate (HR=128/min) and high blood pressure (180/110mmHg), granulomatous lesions in sides of tongue, tenderness in deep palpation in right side of abdomen without organomegaly. A hypodense mass lesion with central necrosis in right adrenal was detected in abdominal CT scanning. In laboratory tests, positive finding was normetanephrine (urine) = 1219μg/24 hr (normal range <600). The pathologic finding approved pheochromocytoma. Conclusion: In children group, sustain hypertension can be a sign of pheochromocytoma after ruling out of other common causes of hypertension. Therefore, a pediatrician should be cautious about this rare disease.