Hypertension in a teenager: a family affair

We present a young, lean, female patient following surveillance by the general practitioner for abnormally high blood pressure readings. Her grandmother died at a young age because of hypertension which shows her family has significant history for hypertension. Her symptoms and signs included feelin...

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Bibliographic Details
Published in:BMJ case reports 2014-01, Vol.2014, p.bcr2013200221
Main Authors: Dubb, Sukhpreet Singh, Tafader, Asiya, Meeran, Karim, Fletcher, Jeremy
Format: Article
Language:English
Subjects:
Adolescent
Adrenal glands
Age
Anemia
Dopamine
Family medical history
Female
Hospitals
Humans
Hypertension
Hypertension - genetics
Iodine
Localization
Metastasis
Migraine
Mutation
Neoplastic Syndromes, Hereditary - complications
Neoplastic Syndromes, Hereditary - genetics
Neoplastic Syndromes, Hereditary - surgery
Paraganglioma - complications
Paraganglioma - genetics
Paraganglioma - surgery
Patients
Rare Disease
Succinate Dehydrogenase - genetics
Thyroid gland
Tumors
United Kingdom
White
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Summary:We present a young, lean, female patient following surveillance by the general practitioner for abnormally high blood pressure readings. Her grandmother died at a young age because of hypertension which shows her family has significant history for hypertension. Her symptoms and signs included feeling hot and nauseous following exercise, sweating and palpitations. Her young age and significant family history immediately prioritises secondary causes including phaeochromocytoma and familial syndromes causing hypertension. Urinary results showed significantly elevated norepinephrine, MRI scanning revealed a mass not within but adjacent to the right adrenal gland while CT-based scanning showed no other ectopics. The patient subsequently underwent surgical intervention at Great Ormond Street Hosptial and following a difficult procedure, that initially started laparoscopically and was converted to open, the tumour was excised. Histopathology and genetic analysis ultimately revealed the patient to have suffered from a paraganglioma type 4 syndrome with a missense mutation of the SDHB gene.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2013-200221