Hipertensão arterial secundária: a propósito de um caso de obstrução da junção pieloureteral

Abstract

Introduction: Secondary hypertension can be identified in a small proportion of patients. Kidney disease, including renal artery stenosis and parenchymal disease, is one of the main causes of secondary hypertension. We report the case of an 18 year-old girl with secondary hypertension due to unilateral ureteropelvic junction obstruction. Case description: An 18 year-old girl presented at an urgent consultation with symptoms of anxiety for two days without a known trigger. On physical examination she had elevated blood pressure and tachycardia. She was treated with an anxiolytic. Because of sustained high blood pressure found on out-of-office blood pressure monitoring, she began antihypertensive drug treatment. The search for secondary causes of hypertension revealed the presence of obstruction of the left ureteropelvic junction causing hydronephrosis. After urological surgery, the patient was asymptomatic. Blood pressure was controlled without antihypertensive drugs. Comment: Unilateral ureteropelvic junction obstruction is a rare cause of hypertension. It is defined as impaired urine flow from the renal pelvis into the proximal ureter with subsequent dilatation of the collecting system. It can cause damage to the kidney. The widespread use of ultrasonography during pregnancy has resulted in a higher detection rate for antenatal ureteropelvic junction obstruction and hydronephrosis. Cases detected in teenagers and adults are rare