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Summary
A rare renin-secreting tumor caused hypertension in a teen. Surgical removal cured the condition, highlighting the importance of plasma renin activity testing for diagnosing primary reninism.
Area of Science:
- Endocrinology
- Nephrology
- Pediatric Hypertension
Background:
- Primary reninism is a rare condition causing hypertension due to excessive renin production.
- Hypertension in adolescents necessitates thorough investigation to identify underlying causes.
Observation:
- A 15-year-old female presented with benign hypertension, normal electrolytes, and unremarkable imaging studies (aortagram, IV pyelogram).
- Diagnosis was challenging, relying heavily on significantly elevated plasma renin activity (PRA).
Findings:
- Selective renal vein catheterization identified a renin-secreting tumor.
- Tumor resection led to the normalization of blood pressure and PRA.
- Propranolol effectively reduced PRA and blood pressure pre-operatively.
Implications:
- This case underscores the diagnostic value of plasma renin activity in primary reninism.
- Early detection and surgical management of renin-secreting tumors can resolve adolescent hypertension.
- Pharmacological management with beta-blockers can be a useful adjunct prior to definitive treatment.