Dolezel Z, Starha J, Pavlovsky Z, Skotakova J, Dostalkova D
Department of Pediatrics, Masaryk University and University Hospital Brno, Czech Republic.
Bratisl Lek Listy. 2010;111(12):653-5.
Secondary hypertension (SH) is much more common in children than in adults. We report a 17-year-old girl with severe hypertension, hypokalemia and metabolic alkalosis. Because of these findings, primary or secondary hyperaldosteronism was suspected. Her initial treatment with spironolactone and ACE inhibitor was unsuccessful. With consideration of high plasma renin activity, the renal computed tomography angiography was performed and showed tumor mass in the left kidney. An uncomplicated partial left nephrectomy was performed. Histopathological examination and electron microscopy showed typical features of juxtaglomerular cell tumor (JCT). Imunohistochemistry of tumor was positive for CD34 and CD117 and this finding is effective in the diagnosis of JCT if immunostain for renin is unavailable. After the resection of JCT, the patient's blood pressure and hypokalemia returned to normal range. JCT is a rare renal neoplasm and an unusual cause of SH in children or adolescents (Fig. 2, Ref. 12).
继发性高血压（SH）在儿童中比在成人中更为常见。我们报告了一名17岁患有严重高血压、低钾血症和代谢性碱中毒的女孩。基于这些发现，怀疑为原发性或继发性醛固酮增多症。她最初使用螺内酯和ACE抑制剂治疗未成功。考虑到高血浆肾素活性，进行了肾脏计算机断层扫描血管造影，显示左肾有肿瘤肿块。实施了无并发症的左肾部分切除术。组织病理学检查和电子显微镜检查显示了肾小球旁细胞瘤（JCT）的典型特征。肿瘤的免疫组织化学检查显示CD34和CD117呈阳性，如果无法进行肾素免疫染色，这一发现对JCT的诊断有效。切除JCT后，患者的血压和低钾血症恢复到正常范围。JCT是一种罕见的肾肿瘤，是儿童或青少年SH的不寻常病因（图2，参考文献12）。
