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[Endocrine and neurogenic hypertension in childhood]
Insights
Endocrine and neurological disorders are rare causes of childhood secondary hypertension, accounting for less than 5% of cases. Specific therapies are available for these conditions, making their identification crucial for pediatricians.
Area of Science:
- Pediatric Endocrinology
- Pediatric Neurology
- Cardiovascular Physiology
Context:
- Secondary arterial hypertension in children is uncommon, with endocrine and neurological conditions accounting for less than 5% of cases.
- While central nervous system disorders rarely cause chronic hypertension, they can precipitate acute hypertensive crises.
- Endocrine disorders, including catecholamine-producing tumors and adrenal cortex conditions, are significant contributors to pediatric hypertension.
Purpose:
- To review the rare endocrine and neurological causes of secondary arterial hypertension in children.
- To highlight the pathophysiology and clinical relevance of neurogenic and endocrine hypertension in pediatric patients.
- To emphasize the importance of identifying these conditions for targeted therapeutic interventions.
Summary:
- Rare causes of childhood secondary hypertension include endocrine diseases (pheochromocytoma, neuroblastoma, Cushing's syndrome, hyperaldosteronism, mineralocorticoid excess) and neurological disorders.
- Central nervous system conditions can lead to acute hypertensive crises, while endocrine disorders are more commonly associated with sustained hypertension.
- Other less frequent causes include renin-producing tumors, hyperthyroidism, and hyperparathyroidism.
Impact:
- Understanding these rare causes improves diagnosis and management of pediatric hypertension.
- Knowledge of neurogenic and endocrine hypertension enhances the understanding of blood pressure regulation.
- Identification of specific underlying causes allows for targeted therapies, improving patient outcomes.
Abstract:
Endocrine and neurological diseases are rare causes of arterial hypertension in childhood. They represent less than 5% of all cases of secondary hypertension. Inflammatory, traumatic, and tumorous disorders of the central nervous system rarely result in chronic hypertension but may frequently be associated with acute hypertensive crisis. The most important hypertensinogenic endocrine diseases are the catecholamine producing tumors pheochromocytoma and neuroblastoma and disorders of the adrenal cortex such as Cushing's syndrome, hyperaldosteronism, 11-hydroxylase deficiency and other mineralocorticoid excess syndromes. Renin producing tumors, hyperthyroidism and hyperparathyroidism are rare causes of hypertension in children. Neurogenic and endocrine forms of hypertension have contributed considerably to a better understanding of the pathophysiology of blood pressure regulation. They are of particular interest to the pediatrician since specific therapy may be available.