Introduction Prevalence of hypertension in children is about 2. The patient was in good physical health with the only past medical complaint of infrequent episodes of asthma. Renal vein renin sampling with lateralization. There was no history of nausea, vomiting, syncope, or visual disturbance. J Hypertens 26 2: Am J Med 43 6: Following the confirmation of the renin-producing tumor in the left kidney, surgical resection of the tumor was performed.
Reninoma of the left kidney. Diagn Pathol 6: Because of the normal appearance of the kidneys, we suspected a renovascular cause of hypertension. Reninoma is a tumor of the renal juxtaglomerular cell apparatus that causes hypertension and hypokalemia via hypersecretion of renin. There was no organomegaly or masses palpable in the abdomen. AU – Hofmann, Lawrence V. We will be provided with an authorization token please note:
Following the confirmation of the renin-producing tumor in the left kidney, surgical resection of the tumor was performed. Similar to our patient, many of the reported cases of reninomas presented with a long-standing history of headaches with a significant delays in diagnosis of hypertension 7911 The biochemical profile on the first blood sample after admission was normal, apart from mild hypokalemia 3.
This case demonstrates the utility of both appropriate imaging studies and selective venous catheterization following provocative administration of an ACE-I for diagnosis.
Reninomas are a rare but curable cause of secondary hypertension.
The patient was placed in the lateral position with left side up. A renin-secreting tumour with severe hypertension and cardiovascular disease: Potassium excretion is commonly within normal daily limits; however, this is inappropriately normal excretion, given the depletion of body potassium stores.
This tumor would also likely have been missed on MRI because of its small size. Histological examination of the tumor revealed a well-circumscribed lesion measuring 15 mm in diameter with cystic and hemorrhagic changes. Imaging studies revealed the presence of a lesion in the renal cortex, which was further identified as a renin-producing lesion via selective venous catheterization following administration of an angiotensin-converting enzyme inhibitor ACE-I.
R ratio of 3. N2 – Reninoma is a tumor of the renal juxtaglomerular cell apparatus that causes hypertension and hypokalemia via hypersecretion of renin.
Reninoma: Case report and literature review
Pathophysiology of metabolic alkalosis: Journal of Hypertension26 2 The tumor cells are characterized by uniform non-enlarged nuclei and a cytoplasm shows numerous pleiomorphic rounded, polygonal, and rhomboidal dense deposits, caee with renin crystals.
Her only medication was over-the-counter analgesia for headaches.
J Urol 1: The tumor comprises a uniform population of round to polyhedral cells with granular, eosinophilic cytoplasm. Hum Pathol 39 3: Reninomas are usually diagnosed in adolescents and young adults with occasional reports in younger children.
Reninoma: case report and literature review. – PubMed – NCBI
Plain radiographs are of limited diagnostic value. Review of juxtaglomerular cell tumor with focus on pathobiological aspect. J Med Assoc Thai. Twenty-four-hour urine collection revealed normal sodium mmol and potassium 53 mmol excretion in 1. Assessment of urinary excretion of electrolytes is useful but requires h collection of urine.
It is important to remember that these medications affect the production and secretion of RAAS hormones reiew thus alter the blood levels of these hormones. Due to the non-specific nature of presenting symptoms headaches and lethargy being the most commonthere is usually a delay in diagnosis of hypertension, sometimes by years.
This case demonstrates the utility of both appropriate imaging studies and selective venous catheterization following provocative administration of an ACE-I for diagnosis. We will be provided with an authorization token please note: We present our approach to diagnostic evaluation of this patient that led us to the correct diagnosis of reninoma, and discuss the medical management and surgical treatment of this rare tumor.
The levels of these hormones can also fluctuate with time, but the elevation above the upper range limit is usually sustained. Laparoscopic wedge resection of reninoma. Detailed ophthalmologic examination did not reveal any hypertensive changes. Am J Clin Pathol 6: We describe a case of reninoma and provide a review of the literature, with a discussion emphasizing the diagnostic evaluation for such patients.