Severe Hypertension in Hypoplastic Kidney and Bilaterial Renal Artery Stenosis: Report of One Case

併發於單側腎臟發育不全及兩側腎動脈狹窄之重度高血壓：一病例報告

鄭敬楓(King-Fung Cheng) ； 曹永魁(Yong-Kwei Tsau) ； 蔡文雄(Wen-Shiung Tsai) ； 陳炯暉(Chiung-Hui Chen)

《Acta Paediatrica Sinica》 34卷6期 (1993/12) Pp. 467-473

摘要

本文報告一3歲男孩因腹痛至急診就醫，而意外發現有重度高血壓(BP=200/110 mmHg）。其臨床症狀表現及理學檢查多不具特異性，僅發現有食慾減低，心率加速(HR=120次／分鐘)及不明顯的持續體重減輕。經住院及系列檢查之安排，包括：腹部及腎臟超音波，經靜脈腎盂造影，核子醫學掃描，選擇性腎靜脈腎素檢查，以及手動脈及腎動脈血管造影後，診斷為原發性腎素分泌過高性高血壓，且合併有單側腎臟發育不全及兩側腎動脈狹窄。病童在接受口服抗高血壓藥物兩星期後，因病況穩定，症狀緩解而出院後定期於門診追蹤。
雖然腎臟性高血壓為孩童期高血壓之一常見病因，但同時合併有單側腎臟發育不全及兩側腎動脈窄縮的病例，乃文獻報告中罕見的情形。
本中將探討其病因及病理機轉，並試圖提出其適當的治療方式。

並列摘要

A three year-old boy was found incidentally to have severe hypertension (around 200/110 mmHg) when he was brought to This Hospital's Emergency Department because of his abdominal pain. After his admission, serial and detailed examinations were performed. These included: basic blood chemistry studies, abdominal and renal sonography, excretory urography, radionuclide scintigraphy and angiography with selective renal vein renin sampling. Diagnosis was made of renovascular hypertension with combination of unilateral renal hypoplasia and bilateral renal artery stenosis. The patient was given oral anti-hypertensive drugs, with resulting satisfactorily controlled blood pressure after two weeks of treatment. He was discharged without surgical intervention.

並列關鍵字

renal hypoplasia ； renovascular hypertension ； renal artery stenosis