KMID : 1130320170600080266
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Korean Journal of Pediatrics 2017 Volume.60 No. 8 p.266 ~ p.271
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Clinical characteristics of hypertensive encephalopathy in pediatric patients
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Ahn Chang-Hoon
Han Seung-A Kong Young-Hwa Kim Sun-Jun
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Abstract
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Purpose: The aim of this study was to assess the clinical characteristics of hypertensive encephalopathy according to the underlying etiologies in children.
Methods: We retrospectively evaluated 33 pediatric patients who were diagnosed as having hypertensive encephalopathy in Chonbuk National University Children¡¯s Hospital. Among the patients, 18 were excluded because of incomplete data or because brain magnetic resonance imaging (MRI) was not performed. Finally, 17 patients were enrolled and divided into a renal-origin hypertension group and a non?renal-origin hypertension group according to the underlying cause. We compared the clinical features and brain MRI findings between the 2 groups.
Results: The renal group included renal artery stenosis (4), acute poststreptococcal glomerulonephritis (2), lupus nephritis (2), and acute renal failure (1); the nonrenal group included essential hypertension (4), pheochromocytoma (2), thyrotoxicosis (1), and acute promyelocytic leukemia (1). The mean systolic blood pressure of the renal group (172.5¡¾36.9 mmHg) was higher than that of the nonrenal group (137.1¡¾11.1 mmHg, P<0.05). Seizure was the most common neurologic symptom, especially in the renal group (P<0.05). Posterior reversible encephalopathy syndrome (PRES), which is the most typical finding of hypertensive encephalopathy, was found predominantly in the renal group as compared with the nonrenal group (66.6% vs. 12.5%, P<0.05).
Conclusion: We conclude that the patients with renal-origin hypertension had a more severe clinical course than those with non?renal-origin hypertension. Furthermore, the renal-origin group was highly associated with PRES on brain MRI.
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KEYWORD
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Child, Hypertension, Encephalopathy, Magnetic resonance imaging
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