Abstract
A 4 years old girl with hypertension (14/7), chronic hypokaliema (1,9 -3,3 mEq/1) alkalosis (pH= 7,52 - 7,47) and renal potassium wastage (urinary potassium 23 -48 mEq/24h) was studied. High exchangeable sodium : 56,7 mEq/kg (N= 45 -50), low plasma renin activity : 6 ng/l/min (N= 26,5 ± 3,1) were associated with low aldosterone secretion rate (S.R.) = 5,56 ug/24h (N= 60 - 150). Low corticosterone S.R. = 0,228 mg/24h (N= 0,50 -0,60), low urinary T.H. DOC : .0,07 mg/24h (N= 0,03 -0,09) and undetectable urinary THS were found. Plasma ACTH was normal 78 -128 pg/ml. The low cortisol S.R. (1,80 mg/24h) rose to 65 mg/24h after ACTH stimulation. Plasma aldosterone rose from 10 to 293 pg/ml after ACTH administration. S.R. of 18 OD DOC was slightly high : 55 μg/24h CN= 20 -40). No urinary 16 OH-DHA could be detected. Low sweat Na/K. ratio (0,25) was observed. Spironoloctones (200 mg/day) and dexamethasone (4 mg/24h for 21 days) induced normal blood pressure (11 -10/6) and kalemia (4,2 - 5,2 mEq/1). This results show that this hypertension and potassium wastage have an adrenal origin. Hyperaldosteronism 11 β- and 170α hydroxylase deficiency could be ruled out. Since the mineralocorticoid potency of 18 OH DOC is weak, the hypersecretion of strong but still unkown mineralocorticoid which could influence ACTH secretion is suggested in this new case of low renin hypertension.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sann, L., Revol, A., Zachmann, M. et al. 32: Unusual low renin hypertension in a child. Pediatr Res 10, 877 (1976). https://doi.org/10.1203/00006450-197610000-00034
Issue Date:
DOI: https://doi.org/10.1203/00006450-197610000-00034