Kim Hwa Young, Kim Jaehyun
Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
Ewha Med J. 2023 Dec;46(Suppl 1):e30. doi: 10.12771/emj.2023.e30. Epub 2023 Dec 31.
Endocrine causes of pediatric hypertension are relatively rare but important because of their distinct treatment options. Adrenal diseases accompanied by an excess of mineralocorticoids, glucocorticoids, and catecholamines are major causes of endocrine hypertension. Typical causes of mineralocorticoid-related hypertension include primary aldosteronism, congenital adrenal hyperplasia (11β- and 17α-hydroxylase deficiencies), and apparent mineralocorticoid excess. Cushing syndrome and pheochromocytoma/paraganglioma are the primary causes of glucocorticoid- and catecholamine-related hypertension, respectively. This review provides an overview of the diagnostic evaluations, including hormonal assays and imaging studies, used to identify the underlying causes of pediatric endocrine hypertension, focusing on adrenal disorders. It presents details regarding the major adrenal disorders and recommended therapeutic approaches, emphasizing the importance of early detection and disease-specific management to prevent cardiovascular and metabolic complications in affected children.
儿童高血压的内分泌病因相对少见，但因其独特的治疗方案而很重要。伴有盐皮质激素、糖皮质激素和儿茶酚胺过多的肾上腺疾病是内分泌性高血压的主要病因。与盐皮质激素相关的高血压的典型病因包括原发性醛固酮增多症、先天性肾上腺增生（11β-和17α-羟化酶缺乏）以及表观盐皮质激素过多。库欣综合征和嗜铬细胞瘤/副神经节瘤分别是与糖皮质激素和儿茶酚胺相关的高血压的主要病因。本综述概述了用于识别儿童内分泌性高血压潜在病因的诊断评估方法，包括激素检测和影像学检查，重点关注肾上腺疾病。它介绍了主要肾上腺疾病的详细情况以及推荐的治疗方法，强调早期检测和针对疾病的管理对于预防患病儿童心血管和代谢并发症的重要性。
