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renovascular hypertension newborn

Donald L Batisky
The incidence of neonatal hypertension (HTN) remains low, at less than 2%, and its etiology is varied. Strict definitions of HTN in neonates are unavailable, and the decision to treat is based on opinion rather than evidence. More studies are needed to define normal blood pressure in neonates and to refine current reference values, thus permitting a better definition of HTN. Most causes of neonatal HTN, the most common of which seems to be renovascular disease, are determined by history and basic clinical investigations...
September 2014: Clinics in Perinatology
Azar Nickavar, Farahnak Assadi
Hypertension in newborn infants, particularly those requiring intensive care, is becoming increasingly recognized, with prevalence of 0.2-3%. Recent studies have established normative tables for blood pressure (BP) in both term and pre-term infants based on the gestational age, postnatal age, gender, weight and height, identifying the neonates at increased risk for early-onset cardiovascular disease. Common causes of neonatal hypertension include thromboembolic complications secondary to umbilical artery catheterization, congenital renal structural malformation, renovascular disease, aortic coarctation, as well as acute kidney injury and certain medications...
March 2014: International Journal of Preventive Medicine
Joe-Elie Salem, Eric Bruguiere, Laurence Iserin, Anne Guiochon-Mantel, Pierre-François Plouin
Alagille syndrome is a rare congenital multisystem disorder that may involve heart disease and pulmonary or peripheral artery stenosis. We report the clinical and radiological presentation of five adult patients with Alagille syndrome, hypertension and renal artery stenosis. All had systolic hypertension and a narrowing of the abdominal aorta, corresponding to a secondary midaortic syndrome. Renovascular disease progressed during follow-up, with increases in blood pressure, decreases in glomerular filtration rate and/or kidney atrophy...
July 2012: Journal of Hypertension
Jarod McAteer, Robert Ricca, Kaj H Johansen, Adam B Goldin
Primary congenital abdominal aortic aneurysm is an extremely rare entity, with only 15 patients reported in the literature. Options for repair are often limited secondary to branch vessel size and other anatomic limitations. We present a neonate diagnosed with an abdominal aortic aneurysm on prenatal ultrasound. A postpartum computed tomography angiogram revealed an extensive type IV thoracoabdominal aortic aneurysm extending to the aortic bifurcation and resulting in bilateral renal artery stenosis. The unique features of this patient and challenges in management are discussed...
June 2012: Journal of Vascular Surgery
José Antonio Hernández-Pacheco, Ariel Estrada-Altamirano, Arlen Valenzuela-Jirón, José Luis Maya-Quiñones, Javier Andrés Carvajal-Valencia, Armando Rogerio Chacón-Solís
Takayasu's arteritis is a chronic and non-specific disease of young women in reproductive age that primarily affects the aorta, its branches and the pulmonary artery. Ramirez Cueto G. and Fernandez Del Castillo C. et al. published a case of pregnancy in Mexico and Takayasu's arteritis in 1968. There are no reports of this disease in pregnancy since. The purpose of this study is to describe the clinical course and perinatal outcome of seven pregnant patients with known diagnosis of Takayasu arteritis. The clinical course, laboratory findings, angiographic findings and perinatal outcomes were assessed in retrospect in seven pregnant patients with diagnosis of Takayasu's arteritis seen at the National Institute of Perinatology Isidro Espinosa Reyes (Mexico) during the period 2002-2010...
March 2011: Ginecología y Obstetricia de México
Jena Fediuk, Alexey Gutsol, Nora Nolette, Shyamala Dakshinamurti
Actin polymerization (APM), regulated by Rho GTPases, promotes myocyte force generation. Hypoxia is known to impede postnatal disassembly of the actin cytoskeleton in pulmonary arterial (PA) myocytes. We compared basal and agonist-induced APM in myocytes from PA and descending aorta (Ao), under hypoxic and normoxic conditions. We also examined effects of thromboxane challenge on force generation and cytoskeletal assembly in resistance PA and renal arteries from neonatal swine with persistent pulmonary hypertension (PPHN) induced by 72-h normobaric hypoxia, compared with age-matched controls...
January 1, 2012: American Journal of Physiology. Lung Cellular and Molecular Physiology
Jayanthi Chandar, Gastón Zilleruelo
Hypertensive crisis is rare in children and is usually secondary to an underlying disease. There is strong evidence that the renin-angiotensin system plays an important role in the genesis of hypertensive crisis. An important principle in the management of children with hypertensive crisis is to determine if severe hypertension is chronic, acute, or acute-on-chronic. When it is associated with signs of end-organ damage such as encephalopathy, congestive cardiac failure or renal failure, there is an emergent need to lower blood pressures to 25-30% of the original value and then accomplish a gradual reduction in blood pressure...
May 2012: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Morel-Elvis Worou, Karim Belmokhtar, Pierre Bonnet, Patrick Vourc'h, Marie-Christine Machet, Georges Khamis, Véronique Eder
AIMS: Angiotensin II induces cardiac myocyte apoptosis and hypertrophy, which contribute to heart failure, possibly through enhanced oxidative stress. The aim of this work was to assess the impact of hemin (heme oxygenase-1 inducer) on NADPH oxidase activation, cardiac oxidative stress, and development of fibrosis in a rat model of renovascular hypertensive cardiomyopathy in comparison to an anti-hypertensive reference treatment with losartan. METHODS AND RESULTS: A 3 week hemin treatment was tested in an angiotensin II-dependent hypertensive rat model and a cellular model of neonatal rat cardiomyocytes stimulated by angiotensin II...
July 15, 2011: Cardiovascular Research
Pannee Visrutaratna, Tanop Srisuwan, Chusak Sirivanichai
BACKGROUND: Renovascular disease is an uncommon but important cause of hypertension in children. When unrecognized and untreated, renovascular hypertension in children can have serious complications. OBJECTIVE: To review the causes of renovascular hypertension and computed tomography angiographic (CTA) findings in children and adolescents. MATERIALS AND METHODS: Twenty-eight CTAs from January 2004 to March 2008 of 23 children and adolescents with hypertension were reviewed for the causes and CTA findings...
December 2009: Pediatric Radiology
George N Sfakianakis, Efrosyni Sfakianaki, Mike Georgiou, Aldo Serafini, Shabbir Ezuddin, Russ Kuker, Gaston Zilleruelo, Jose Strauss, Carolyn Abitbol, Jayanthi Chandar, Wacharee Seeherunvong, Jacque Bourgoignie, David Roth, Raymond Leveillee, Vincent G Bird, Norman Block, Rafael Gosalbez, Andrew Labbie, Jorge J Guerra, Jose Yrizarry
Current clinical requirements mandate the existence of a renal diuretic protocol, which is fast and easy, applicable in all ages and for all indications, convenient for both the patient and the technologist, and provides diagnostic as well as prognostic information. Seventeen years ago a 25-minute protocol, after oral hydration, with no bladder catheterization, and simultaneous injection of mercapto-acetyl-triglycine (MAG(3)) and furosemide (MAG(3)-F(0)), was initiated. It initially was used for the evaluation of drainage and emerged as a protocol to also evaluate the renal parenchyma...
May 2009: Seminars in Nuclear Medicine
Christine B Sethna, Bernard S Kaplan, Anne Marie Cahill, Omaida C Velazquez, Kevin E C Meyers
Mid-aortic syndrome (MAS) is an uncommon condition characterized by narrowing of the abdominal aorta and stenosis of its major branches. Our goal was to illustrate the presentation, diagnosis and management of six new cases of idiopathic MAS together with 96 cases of idiopathic MAS from the literature. The mean age of the 102 cases was 14.3 years (19 days to 49 years). Our patient who presented at 19 days of age is the youngest reported to date. Clinical presentations included hypertension (94%), claudication (17%), renal failure (4%) and intestinal ischemia (1%)...
July 2008: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Larisia Mihai
Hypertension in the neonate is a rare disease. Although the definition of hypertension in this age group has not been completely standardized, recent studies have provided new normative data that may be used to facilitate identification of such infants. The most common causes of clinically and treatable hypertension in neonates is renal artery occlusion due to thromboembolic events related to umbilical catheterization. Additionally, congenital problems such as aortic coarctation, structural renal malformations and renovascular disease, as well as acquired renal disease and certain medications must always be considered...
July 2007: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
Bibhuti B Das, Michael Recto, Lawrence Shoemaker, Michael Mitchell, Erle H Austin
We describe a case of mid-aortic syndrome presenting as systemic hypertension in infancy and early childhood. Angiography of the descending and abdominal aorta is the diagnostic test of choice to confirm the diagnosis of mid-aortic syndrome. Severity of hypertension is one of the major factors in determining the timing of intervention. Because of variability in the anatomic extent of mid-aortic syndrome, management options need to be individualized.
September 2008: Pediatric Cardiology
H S Lam, W C W Chu, C H Lee, W Wong, P C Ng
No abstract text is available yet for this article.
July 2007: Archives of Disease in Childhood. Fetal and Neonatal Edition
Aysun K Bayazit, Fatos Yalcinkaya, Nilgun Cakar, Ali Duzova, Zelal Bircan, Aysin Bakkaloglu, Nur Canpolat, Nazl Kara, Aydan Sirin, Mesiha Ekim, Ayse Oner, Sema Akman, Sevgi Mir, Esra Baskin, Hakan M Poyrazoglu, Aytul Noyan, Ipek Akil, Sevcan Bakkaloglu, Alper Soylu
Renovascular disease accounts for 8-10% of all cases of paediatric hypertension, whereas, in adults, its incidence is approximately 1%. The Turkish Paediatric Hypertension Group aimed to create the first registry database for childhood renovascular hypertension in Turkey. Twenty of the 28 paediatric nephrology centres in Turkey responded to the survey and reported 45 patients (27 girls, 18 boys) with renovascular hypertension between 1990 and 2005. The age at presentation ranged from 20 days to 17 years. The mean blood pressure at the diagnosis was 169/110 mmHg...
September 2007: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Stefan G Kiessling, Nitin Wadhwa, Vesna M Kriss, Joseph Iocono, Nirmala S Desai
Hypertension can occur in up to 2% of neonates, and the spectrum of potential causes is broad. Prompt and thorough evaluation with a main focus on kidney disease is key for appropriate therapy. Here we describe a 2-day-old neonate with feeding intolerance and elevated blood pressure readings. Within 24 hours after birth, the infant's blood pressure increased significantly, with sustained mean arterial pressure >85. Renal Doppler ultrasound showed decreased venous blood flow in the right kidney with an abnormal Doppler wave form suggestive of unilateral renal venous thrombosis...
January 2007: Pediatrics
Achra Sumboonnanonda, Chollamalee Chongcharoensuk, Suroj Supavekin, Anirut Pattaragarn
A retrospective study was done in 66 children (0.21% of all admitted children) below the age of 18 years with persistent hypertension diagnosed at the Department of Pediatrics, Faculty of Medicine Siriraj Hospital from Jan 1999 to Dec 2003. Male to female ratio was 1.4:1 with 54.5% aged between 6-12 years old and 9.1% aged less than 1 year. Hypertension was found to be severe (BP more than the 99th percentile for age, sex and height) in 79.1% but most (78.6%) of the patients did not have symptoms related to hypertension...
August 2006: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Shivaram Hegde, Christopher Wright, Mohan Shenoy, Nadeem E Moghal, Malcolm G Coulthard
We report three infants with severe, early hypertension due to unilateral renovascular disease, whose cardiovascular changes, or polycythaemia, or both, indicated they had been affected as fetuses. All underwent unilateral nephrectomy, and had a similar histology, with patchy areas having relatively normal glomeruli but immature proximal tubules. This pattern may be a marker for renovascular disease in fetal life.
July 2007: Archives of Disease in Childhood. Fetal and Neonatal Edition
Amy L Peterson, Peter C Frommelt, Kathy Mussatto
BACKGROUND: Systemic hypertension is a rare but important cause of neonatal heart failure. It is critical that this etiology be recognized and distinguished from other causes of myocardial dysfunction in young infants, because diagnostic studies, treatments, and prognoses are quite different. METHODS: Between 1991 and 2005, 11 neonates were diagnosed as having neonatal cardiomyopathy and systemic hypertension through retrospective review of the Children's Hospital of Wisconsin database...
September 2006: Pediatrics
Rémi Salomon
Measuring blood pressure is more difficult in children than in adults and requires special blood pressure cuffs. Hypertension is defined by values established according to sex and height. A cause must always be sought; it will most often be renovascular. Essential hypertension is exceptional in children younger than 7 years, but is increasingly frequent in adolescents because of the growing prevalence of obesity. Hypertension in newborns and babies is often revealed by heart failure.
June 2006: La Presse Médicale
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