HYPERTENSION SECONDARY TO RENIN-SECRETING JUXTAGLOMERULAR CELL TUMOR - CASE-REPORT AND REVIEW OF 38 CASES

A 15-year-old girl with severe high renin hypertension caused by a jux taglomerular cell tumor (JCT) was successfully treated with the calciu m channel blocker nifedipine until surgical removal effected a permane nt cure. This case was incorporated into a review of the 37 cases prev iously published. Comparison of the children and adolescents with the adult population showed that the features of JCT were similar in the t wo groups except for the average duration of symptoms prior to diagnos is (pediatric group 2.6 years vs. 6.0 years for the adult group). Anal ysis of all 38 cases demonstrated the following: 1 .Teenagers constitu ted the largest single population with JCT (39%) and approximately two -thirds of the entire population were female. 2. Many patients failed to show persistent hypokalemia despite high plasma renin activity and secondary hyperaldosteronism. 3. Renal angiography was initially negat ive in more than half the cases. 4. Renal vein renin failed to show la teralization to the affected kidney in 52% of the cases. 5. Computeriz ed tomography demonstrated a renal mass in all of the cases in which i t was performed, even when other imaging studies were negative. 6. Cal cium channel blockers may evolve as the preferred treatment for the hi gh renin hypertension of JCT.