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Pediatric hypertension: an approach to imaging

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Abstract

Since 1981, we have made diagnoses of secondary hypertension using state of art imaging equipment in 18 pediatric patients. The most valuable tests were ultrasound in identifying renal parenchymal disease, computed body tomography for adrenal tumors and intra-arterial renal angiography for renovascular disorders. Based on our experience, we have formulated an algorithm for the evaluation of the hypertensive pediatric patient. The initial step is careful clinical and laboratory screening to identify those patients that are likely to have essential hypertension and who should not undergo imaging tests. In the cases where there is a possible secondary etiology, renal ultrasound is usually performed first to identify parenchymal disease. If catecholamines are elevated, then abdominal computed tomography is the initial test. If no etiology is identified from these noninvasive studies, then direct intraarterial renal angiography is performed. The authors do not feel that excretory urography, radionuclide renography, intravenous digital subtraction angiography or selective renal vein sampling for renin are useful or practical screening tests for renovascular hypertension.

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References

  1. Kotchen TA, Kotchen JM (1983) Significances of high blood pressure in the young. In: Kotchen TA, Kotchen JM (eds) Clinical approaches to high blood pressure in the young. John Wright, Littleton, MA, p 1

    Google Scholar 

  2. Report of the task force on blood pressure control in children (1977) Pediatrics 59: 797

    Google Scholar 

  3. Olson DL, Lieberman E (1976) Renal hypertension in children. Pediatr Clin North Am 23: 795

    CAS  PubMed  Google Scholar 

  4. Turner M, DeQuattro V, Falk F, Ansari A, Lieberman E (1986) Childhood familial pheochromocytoma: conflicting results of localization techniques. Hypertension (in press)

  5. Stanley P, Diament MJ (1984) Intra-arterial DSA in children. Radiology 153: 172 (Abstract)

    Google Scholar 

  6. Stanley P, Hieshima G, Mehringer M (1984) Percutaneous transluminal angioplasty for pediatric renovascular hypertension. Pediatr Radiol 153: 101

    CAS  Google Scholar 

  7. Mena E, Bookstein JJ, Holt JF, et al (1973) Neurofibromatosis and renovascular hypertension in children. Am J Roentgenol 118: 39

    CAS  Google Scholar 

  8. Glushien AS, Mansy MM, Littman DS (1953) Pheochromocytoma: its relationship to neurocutaneous syndromes. Am J Med 14: 318

    Article  CAS  PubMed  Google Scholar 

  9. Lieberman E (1986) Hypertension in childhood and adolescence. In: Kaplan H (ed) Clinical hypertension, 4th edn. Williams and Wilkins, Baltimore (in press)

    Google Scholar 

  10. Farrelly CA, Daneman A, Martin DJ, et al (1984) Pheochromocytoma in childhood: the important role of computed tomography in tumor localization. Pediatr Radiol 14: 210–214

    Article  CAS  PubMed  Google Scholar 

  11. Stanley P, Gyepes MT, Olson DL, Gates GF (1978) Renovascular hypertension in children and adolescents. Radiology 129: 123

    CAS  PubMed  Google Scholar 

  12. Stanley JC, Fry WJ (1981) Pediatric renal occlusive disease and renovascular hypertension. Etiology, diagnosis, and operative treatment. Arch Surg 116: 669

    CAS  PubMed  Google Scholar 

  13. Hillman BJ, Ovitt TW, Capp MP (1982) The potential impact of digital video subtraction angiography on screening for renovascular hypertension. Radiology 1142:577

    Google Scholar 

  14. Hillman BJ, Ovitt TW, Capp MP (1982) The potential impact of digital video subtraction angiography on screening for renovascular hypertension. Radiology 1142:577

    Google Scholar 

  15. Gomes AS, Pais SO, Barbaric ZL (1983) Digital substraction angiography in the evaluation of hypertension. AJR 140:779

    CAS  PubMed  Google Scholar 

  16. Watson AR, Balfe JW, Hardy BE (1985) Renovascular hypertension in childhood: a changing perspective in management. J Pediatr 106:366

    CAS  PubMed  Google Scholar 

  17. Kirks DR, Fitz CR, Korobkin M (1977) Intrarenal collateral circulation in the pediatric patient. Pediatr Radiol 5:154

    Article  CAS  PubMed  Google Scholar 

  18. Doody PT, Wombolt DG, Tynes WV, et al. (1982) Intrarenal arterial stenosis. Clin Pediatr 21:32

    CAS  Google Scholar 

  19. Ernest CB (1983) Childhood renovascular hypertension. In: Kotchen TA, Kotchen JM (eds) Clinical approaches to high blood pressure in the young. John Wright, Littleton, Mass, p 151

    Google Scholar 

  20. Gillespie L, Elnrlich RM, Marks LS, et al (1980) Use of saralasin to detect renovascular hypertension in childhood. Urology 16:453

    Article  CAS  PubMed  Google Scholar 

  21. Ganguly A, Bergstein J, Grim CE, et al. (1980) Childhood primary aldosteronism due to an adrenal adenoma: preoperative localization by adrenal vein catheterization. Pediatrics 65:605

    CAS  PubMed  Google Scholar 

  22. Maxwell MH, Waks AU (1984) Evaluation of patients with renovascular hypertension. Hypertension 6:589

    CAS  PubMed  Google Scholar 

  23. Gelfand DW, Ott DJ (1985) Methodologic considerations in comparing imaging methods. AJR 144:117

    Google Scholar 

  24. Kangarloo H, Gold RH, Fine RN, Diament MJ, Boechat MI (1985) Urinary tract infection in infants and children evaluated by ultrasound. Radiology 154:367

    CAS  PubMed  Google Scholar 

  25. Stringer DA, deBruyn R, Dillon MJ, Gordon I (1984) Comparison of aortography, renal vein renin sampling, radionuclide scans, ultrasound and the IVU in the investigation of childhood renovascular hypertension. Br J Radiol 57:111

    CAS  PubMed  Google Scholar 

  26. Rosen PR, Treves S, Ingelfinger J (1985) Hypertension in children. AJDC 139:173

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiologic Sciences, UCLA Center for the Health Sciences, Los Angeles, California, USA

    M. I. Boechat & H. Kangarloo

  2. Department of Pediatrics, Division of Nephrology, Childrens Hospital of Los Angeles, Los Angeles, California, USA

    E. R. Lieberman

  3. Department of Radiology, Childrens Hospital, 90024, Los Angeles, California, USA

    M. J. Diament, P. Stanley & V. Gilsanz

Authors
  1. M. J. Diament
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  2. P. Stanley
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  3. M. I. Boechat
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  4. H. Kangarloo
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  5. V. Gilsanz
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  6. E. R. Lieberman
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Diament, M.J., Stanley, P., Boechat, M.I. et al. Pediatric hypertension: an approach to imaging. Pediatr Radiol 16, 461–467 (1986). https://doi.org/10.1007/BF02387958

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  • DOI: https://doi.org/10.1007/BF02387958

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