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Hypertension in Pheochromocytoma and Paraganglioma: Evaluation and Management in Pediatric Patients

Meredith L Seamon1, Ikuyo Yamaguchi2

  • 1Division of Pediatric Nephrology, Department of Pediatrics, University of Utah, 81 N. Mario Capecchi Drive, Salt Lake City, UT, 84113, USA. meredith.seamon@hsc.utah.edu.

Current Hypertension Reports
|May 27, 2021
PubMed

Insights

Managing blood pressure in pediatric patients with pheochromocytomas and paragangliomas (PPGL) is challenging. Selective alpha-blockers and calcium channel blockers are increasingly used for perioperative care due to better safety and availability.

Area of Science:

  • Pediatric Endocrinology
  • Cardiovascular Pharmacology
  • Oncology

Background:

  • Pheochromocytomas and paragangliomas (PPGL) are rare tumors causing secondary hypertension in children.
  • Perioperative blood pressure management in pediatric patients with PPGL is a significant clinical challenge.

Purpose of the Study:

  • To review antihypertensive treatment options for pediatric patients with PPGL.
  • To focus on recent literature regarding perioperative blood pressure management in this population.

Main Methods:

  • Literature review focusing on studies from the past several years.
  • Analysis of case series and single-center experiences for treatment guidelines.

Main Results:

  • Phenoxybenzamine, selective α1-blockers (e.g., doxazosin), and calcium channel blockers have been used successfully.
  • Current pediatric practice and international guidelines support preoperative α-adrenergic blockade.
  • Selective α1-blockers and calcium channel blockers are gaining favor over phenoxybenzamine due to cost, availability, and side effect profiles.

Conclusions:

  • Selective α1-blockers and calcium channel blockers represent viable and often preferred alternatives to phenoxybenzamine for perioperative management of pediatric PPGL.
  • Continued adherence to preoperative α-adrenergic blockade is recommended for optimal patient outcomes in pediatric PPGL management.
Abstract

Keywords:
AmlodipineDoxazosinHypertensionParagangliomas (PGL)PediatricsPheochromocytomas (PCC)

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