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- Title
Severe labile hypertension in a patient with catecholamine-secreting neuroblastoma: a case report.
- Authors
Frisby-Zedan, Jeanne; Migotsky, Michael; Walterhouse, David O.; Verghese, Priya S.
- Abstract
Neuroblastoma is a common pediatric tumor arising from the post-ganglionic sympathetic nervous system and is associated with hypertension in 25% of cases. We describe an unusual case of labile, multi-drug resistant hypertension associated with chemotherapy administration for neuroblastoma and provide potential management strategies in this scenario. We report the case of a 4-year-old female with a history of headaches who presented with hypertensive emergency and evidence of end-organ damage, including posterior reversible encephalopathy syndrome, acute cerebral infarct, concentric left ventricular hypertrophy, and growth failure secondary to a large, abdominal catecholamine-secreting neuroblastoma, which compressed the kidney vasculature and inferior vena cava. She was classified as intermediate risk according to Children's Oncology Group criteria and underwent chemotherapy, complicated by labile hypertension, followed by surgical resection. Vigilance in monitoring and treatment of hypertension is recommended during chemotherapy for neuroblastoma due to the potential catecholamine release in the setting of tumor lysis.
- Subjects
HYPERTENSIVE crisis; HYPERTENSION; COMPUTED tomography; MULTIPLE organ failure; MULTIDRUG resistance; SEVERITY of illness index; MAGNETIC resonance imaging; ANTIHYPERTENSIVE agents; CANCER chemotherapy; LEFT ventricular hypertrophy; FAILURE to thrive syndrome; CATECHOLAMINES; CEREBRAL infarction; NEUROBLASTOMA; POSTERIOR leukoencephalopathy syndrome; DISEASE complications
- Publication
Pediatric Nephrology, 2024, Vol 39, Issue 7, p2087
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-023-06269-2