Juxtaglomerular cell tumor (JGCT), or reninoma, is a rare renin producing benign neoplasm arising from the juxtaglomerular cell apparatus, generally affecting young adults and adolescents. Clinically, it presents with secondary hypertension and hypokalemia. Since reninoma is curable by surgical resection, it becomes necessary to consider JGCT as a possible differential in patients presenting with secondary hypertension, hypokalemia and excessive renin secretion. Herein we describe a case of a young female presenting with hypertension and a single renal mass.
Case Report
A 24 year old obese Caucasian female presented to the nephrology clinic with longstanding history of hypertension since 18 years of age. Her high blood pressure was associated
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Apporoximately 100 cases of JGCT have been reported in English literature. It was first described by Robertson et al in 1967 and was given this name by Kihara in 1968 (1, 2). It is seen predominantly in females in second and third decades of life (3-5). Although some cases have been reported in patients who are more than 40 years old (4) as well as in children of less than 10 years age. Most of the symptoms are attributed to hypertension, hypokalemia, hyperaldosteronism and increased renin activity due to secretion by the tumor. These non-specific symptoms are headaches, retinopathy , double vision, dizziness, nausea, vomiting, polyuria and proteinuria (3, 6). Hypertension is mostly present for several years before the diagnosis of reninoma is made. No correlation has been reported of degree or duration of hypertension with tumor size. Three clinical variants have been reported so far: ‘typical variant’ presenting with hypertension, hypokalemia, increased plasma renin secretion and hyperaldosteronism; ‘atypical variant’ presenting with hypertension but without hypokalemia; ‘non-functioning variant’ presenting without hypertension (12). Endoh et al reported a case of non-functioning variant which was discovered incidentally (7). Our patient presented with hypertension, headaches and hypokalemia and increased plasma renin
Blood pressure measurements on adult males 30-39 years of age were obtained in a survey of a representative sample of Twin Cities households. To compare the frequency of hypertension in the white and non-white population surveyed, the most appropriate measure is the
Table - 1: Frequency of individual benign tumors in different age groups. Histological type Age in years 0-20 21-30 31-40 41-50 51-60 61-70 >70 Total Serous cystadenoma 2 6 20 6 3 1 1 39 Mucinous cystadenoma 2 4 7 3 3 1 1 21 Cystadeno- fibroma 1 1 Benign mature teratoma 1 5 1 7
Many types of neoplasms have been associated with PS, including ovarian, testicular, meningeal, and parotid tumors. Some tumors are rare in the general population under 20 years of age, e.g., ovarian cystadenoma, and monomorphic adenoma of parotid gland. Sometimes multiple tumors have been recorded in same patient. Lipomas are common but other neoplasms occur with low frequency. Most neoplasms originate before 20 years
Hypertension is a condition of the heart where excessive amount of pressure is introduced in the blood vessels. The excessive pressure created in the blood vessels causes a lot of damage to the vessels and can lead to serious complications. This condition can affect everybody but the chances of acquiring these diseases are high in older people. Specific for Hispanics, they stand a higher chance of developing hypertension than other lineages in America. Some of the diseases they are prone to are cardiovascular, obesity in young people and diabetes.
Infantile hemangioma (IH), a benign vascular tumor, is the most common tumor of infancy, with an incidence of 5%–10% at the end of the first year (1). Most lesions are not visible at birth but appear in the first four to six weeks of life. Hemangiomas are characterized by a growth phase which continues for the first year followed by a involution phase lasting from one to nine years (1). Risk factors for development of hemangiomas are being female, Caucasian, low birth weight, and those of multiple gestations (1). The cause
(2012), it was verified that the increased prevalence of chronic kidney disease is a consequence of the accumulation of risk factors, one of which is hypertension. It is also associated with increased risk of not only progression to renal failure but also excess cardiovascular morbidity and mortality in a manner independent of other known risk factors (Yano et al., 2012). The research was conducted with 232,025 patients in a Japanese nationwide database with a focus on the prevalence and risk factors of chronic kidney disease in prehypertension. The prevalence of chronic kidney disease among patients with hypertension was 20.7% in men and 15.0 % in women (Yano et al., 2012).
A forty-nine-year-old patient with a health history of essential hypertension reports spells of dyspnea upon moderate exertion, and epistaxis accompanied by vertigo and blurred vision. The patient also reports cessation of prescribed antihypertensive medication the previous year. Upon examination, the patient’s blood pressure (BP) is 180/110, and during thoracic cavity auscultation rales are noted. The doctor then orders tests and directs the patient to resume taking the previously prescribed antihypertensive medication.
The anterior pituitary is the front portion of the pituitary gland which is a small gland in the head called the master gland. Certain hormones that are secreted by the anterior pituitary influence growth, sexual development, skin pigmentation, thyroid function, and adrenocortical function. The anterior pituitary gland is a major organ of the endocrine system. The anterior pituitary, is the glandular, anterior lobe that together with the posterior lobe (posterior pituitary, or the neurohypophysis) makes up the pituitary gland (hypophysis) (Oxford University Press, 2015). Some of the hormones that are secreted are growth hormone, luteinizing hormone, follicle stimulating hormone, adrenocorticotropic
Due to the presence of internal hemorrhage, necrosis, and calcifications, these tumors tend to vary in appearance with frequent heterogeneous enhancement. They are bilateral in 2% to 10% of cases.
Licorice probably one of the worlds oldest and most popular candies. Although, licorice is such a great tasting candy the candy is one of the leading connections to hypertension. Hypertension is a term commonly used to describe chronically elevated high blood pressure. The two terms high blood pressure and hypertension can be used interchangeably though. There are two types of hypertension: essential and secondary. Essential hypertension is when there is no specific cause that can be identified to explain the existing heart condition. Secondary hypertension indicates that high blood pressure is an alert to other preexisting conditions. The causes of secondary hypertension is diabetes, kidney disease, thyroid problems, sleep apnea, obesity, pregnancy,
Diagnosis: pale and diaphoretic, low levels of BUN (29) and Creatinine (2.0), hypertensive renal disease
Hypertension may be divided into two categories, primary (essential) or secondary. Primary hypertension refers to an elevated blood pressure that occurs with no other cause or evidence of other diseases or conditions, and accounts for 90% of cases. Secondary hypertension is when the elevated blood pressure comes secondary, or as a result of, another disease or disorder, such as glomerulonephritis, pyelonephritis, or disease of the adrenal glands (Chabner, 2014, p. 422). Local hypertension is also a possibility, where high blood pressure occurs only in a specific area of the body, such as portal hypertension or pulmonary hypertension (Adams & Urban, 2016, p. 543). Hypertension is diagnosed when an individual’s systolic blood pressure is consistently elevated (during multiple measurements) to 140 mmHg, or when diastolic is 90 mmHg or above.
Benign SCT are usually asymptomatic in utero and diagnosed antenatally. Symptoms, if present, are caused by the pressure of the tumor on the nearby organs and include bowel dysfunction (constipation up to colon obstruction), venous and lymphatic obstruction of the legs resulting in lower limb edema. The presence of symptoms usually suggests a malignant lesion. Urinary symptoms are very rare even in malignant tumors[5]. We searched the literature for reported cases of urine retention caused by SCT and found only few sporadic cases reported.
Treatment often depends on the condition that is causing hypertension to occur. Other diseases, such as kidney disease, can cause high blood pressure. In cases such as this, the condition is known as secondary hypertension and the root cause must be addressed in order to lower blood pressure. Primary hypertension, where the blood pressure is high due to no other causes, can be treated through dietary changes, exercise and medication.
The two major types of hypertension are primary and secondary. Primary hypertension accounts for more than 90% of all cases and has no known cause, although it is hypothesized that genetic factors, hormonal changes, and the altercations in sympathetic tone all may play a role in its development. Secondary hypertension develops as a consequence of an underlying disease or condition. The prevention and treatment of hypertension is a major public health issue. When blood pressure is controlled, cardiovascular, renal disease, and stroke may be prevented. The JCN, reported more than 122 million individuals in American are overweight or obese, consume large amounts of dietary sodium and alcohol, and do not eat adequate amounts of fruits and vegetables; less than 20% exercise regularly. Both modifiable and non-modifiable factors play a role in the development of hypertension