Abstract
Ten infants less than three months of age were found to have severe hypertension (140 to 170 mm Hg systolic). Of the ten infants, four weighed less than 5 lbs. at birth, six had respiratory distress syndrome, three had patent ductus arteriosus, eight had hematuria, and eight had umbilical arterial catheters in place for 5 to 74 days.
Aortography demonstrated a cause of the hypertension in all 6 infants studied. Five of these studies demonstrated thrombi in the aorta and/or the renal arteries. The sixth infant had renal artery stenosis. Two additional infants had aortic and renal arterial thrombi demonstrated at autopsy. A variety of antihypertensive drugs were administered in high doses with a generally poor response. Five infants died. Three recovered spontaneously, including one with a documented renal artery thrombus and the two who were not studied. Two infants recovered following nephrectomy.
Hypertension in the young infant carries a high mortality rate. Response to medical management may be unsatisfactory. Aortography has a high yield and should be performed early followed by surgery if indicated.
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Plumer, L., Kaplan, G. & Mendoza, S. HYPERTENSION IN INFANTS. Pediatr Res 8, 459 (1974). https://doi.org/10.1203/00006450-197404000-00717
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DOI: https://doi.org/10.1203/00006450-197404000-00717