KOSIN UNIVERSITY COLLEGE OF MEDICINE
Articles
- Page Path
- HOME > Kosin Med J > Volume 33(1); 2018 > Article
-
Case Report
Increased arterial stiffness causing resistant hypertension in an adolescent with Neurofibromatosis type 1 - Min Jung Cho
-
Kosin Medical Journal 2018;33(1):105-109.
DOI: https://doi.org/10.7180/kmj.2018.33.1.105
Published online: January 21, 2018
Department of Pediatrics, Pusan National University Hospital, Busan, Korea
- Corresponding Author: Min Jung Cho, Department of Pediatrics, Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan 49241, Korea Tel: +82-51-240-7800 Fax: +82-51-248-6205 E-mail: mjchomd@gmail.com
• Received: August 23, 2017 • Accepted: September 27, 2017
Copyright © 2018 Kosin University School of Medicine Proceedings
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
- 779 Views
- 0 Download
Abstract
- Neurofibromatosis type 1 is an autosomal dominant genetic disorder characterized by the presence of café au lait spots, axillary and inguinal freckling, Lisch nodules, and neurofibromas. Hypertension is a relatively frequent complication, usually caused by renal artery stenosis or pheochromocytomas. We describe the case of a 15-year-old boy with neurofibromatosis type 1 who was also diagnosed with resistant hypertension. Despite an extensive evaluation, the etiology of his hypertension remained indeterminate. Estimation of the brachial-ankle pulse wave velocity and ambulatory arterial stiffness index could validate the existence of arterial stiffness. Further, a combination of carvedilol and angiotension receptor blockers was administered, which successfully controlled his resistant hypertension. We propose that the estimation of the brachial-ankle pulse wave velocity measure and ambulatory arterial stiffness index is a noninvasive method, and these two parameters are relatively simple tools that can be used for the detection of arterial stiffness due to neurofibromatosis type 1-related vasculopathy.
Fig. 1.Brachial-ankle pulse wave velocities. Markedly elevated for his age; 1305 cm/s for right and 1390 cm/s for left
- 1.Listernick R, Charrow J. Neurofibromatosis type 1 in childhood. J Pediatr 1990;116:845–53.ArticlePubMed
- 2.Virdis R, Balestrazzi P, Zampolli M, Donadio A, Street M, Lorenzetti E. Hypertension in children with neurofibromatosis. J Hum Hypertens 1994;8:395–7.PubMed
- 3.Reisch N, Peczkowska M, Januszewicz A, Neumann HP. Pheochromocytoma: presentation, diagnosis and treatment. J Hypertens 2006;24:2331–9.ArticlePubMed
- 4.Lama G, Graziano L, Calabrese E, Grassia C, Rambaldi PF, Cioce F, et al. Blood pressure and cardiovascular involvement in children with neurofibromatosis type1. Pediatr Nephrol 2004;19:413–8.ArticlePubMed
- 5.Riccardi VM. Von Recklinghausen neurofibromatosis. N Engl J Med 1981;305:1617–27.ArticlePubMed
- 6.Urbina EM, Williams RV, Alpert BS, Collins RT, Daniels SR, Hayman L, et al. Noninvasive assessment of subclinical atherosclerosis in children and adolescents: recommendations for standard assessment for clinical research: a scientific statement from the American Heart Association. Hypertension 2009;54:919–50.ArticlePubMed
- 7.Payne RA, Wilkinson IB, Webb DJ. Arterial stiffness and hypertension: emerging concepts. Hypertension 2010;55:9–14.ArticlePubMed
- 8.Simonetti GD, VON Vigier RO, Wühl E, Mohaupt MG. Ambulatory arterial stiffness index is increased in hypertensive childhood disease. Pediatr Res 2008;64:303–7.ArticlePubMed
- 9.Chen X, Huang B, Liu M, Li X. Effects of different types of antihypertensive agents on arterial stiffness: a systematic review and meta-analysis of randomized controlled trials. J Thorac Dis 2015;7:2339–47.PubMedPMC
References
Figure & Data
References
Citations
Citations to this article as recorded by 
PubReader
Cite
XML Download
