[A rare cause of hypertension with hypokalemia: A case of reninoma].

Autor: Zimmermann Y; Service de néphrologie, hôpital Riviera-Chablais site de Rennaz, route du Vieux Sequoia 20, 1847 Rennaz, Suisse., Tawadros C; Service d'urologie, hôpital Riviera-Chablais site de Rennaz, 1847 Rennaz, Suisse., Andrejevic-Blant S; Centre de pathologie, Aurigen, 1004 Lausanne, Suisse., Vogel G; Service de néphrologie, hôpital Riviera-Chablais site de Rennaz, route du Vieux Sequoia 20, 1847 Rennaz, Suisse. Electronic address: gerard.vogel@hopitalrivierachablais.ch.
Jazyk: francouzština
Zdroj: Nephrologie & therapeutique [Nephrol Ther] 2021 Dec; Vol. 17 (7), pp. 538-542. Date of Electronic Publication: 2021 Jul 30.
DOI: 10.1016/j.nephro.2021.05.005
Abstrakt: Reninoma or juxtaglomerular cell tumor is a rare usually benign renal renin secreting tumor. We report the case of an 18-year old woman, without any medical history, investigated in our hospital's emergency department for a bilateral papilledema. Ambulatory ophthalmological investigations were performed because of a newly occurring blurry vision, associated with diffuse headaches. Cerebral mRI and lumbar puncture recommended by the ophthalmologist and neurologist excluded intra-cranial hypertension. The patient presented with severe hypertension. Laboratory values showed hypokalemia, compensated metabolic alkalosis and microalbuminuria. During the hospital stay, she developed AKIN 1 acute renal injury. Ultrasound revealed a tissular cystic lesion of the superior pole of the right kidney. Abdominal mRI confirmed the lesion and raised suspicion for a renal cell carcinoma without calicial or vascular invasion. Plasma renin value was >500 mUI/L with normal values for plasma aldosterone. Renal biopsy diagnosed a juxtaglomerular cell tumor. After an aggressive initial treatment, hypertension remained well controlled with spironolactone only, finally allowing for withdrawal of all antihypertensive medications. Robot-assisted laparoscopic partial nephrectomy was performed. Studies of the operative specimen confirmed the diagnosis of benign reninoma. Clinical follow-up showed complete resolution of clinical and biological parameters.
(Copyright © 2021 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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