Focal Segmental Glomerulosclerosis Secondary to Juxtaglomerular Cell Tumor during Pregnancy: A Case Report

Ohashi, Yasushi; Kobayashi, S; Arai, Taichi; Nemoto, Tetsuo; Aoki, Chizu; Nagata, Michio; Sakai, Ken

doi:10.1159/000362757

Cited by 9 publications

(7 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Among the number of reninoma cases reported (12)(13)(14)(15)(16)(17), the patient of the present study case is the 7th study reporting a patient with reninoma during pregnancy. According to previous studies, the majority of reninomas present in the form of solitary tumor (11,18).…”

Section: Discussionmentioning

confidence: 79%

Reninoma coexisting with adrenal adenoma during pregnancy: A case report

et al. 2017

View full text Add to dashboard Cite

Abstract. Reninoma is a rare form of secondary hypertension. The present study reported a case of reninoma that coexisted with an adrenal adenoma in a young female with secondary hypertension during pregnancy. The patient, a 31-year-old female exhibiting hypertension for >1 year, developed a mass in the right adrenal gland, which was detected by an ultrasound scan in the 33rd gestational week. In addition, a well-defined solid mass on the left kidney was detected by a magnetic resonance imaging scan1 month subsequent to the termination of the pregnancy. The blood pressure (BP) of the patient did not change subsequent to the laparoscopic right adrenalectomy. The patient subsequently underwent laparoscopic left partial nephrectomy 2 months later. The BP levels demonstrated a significant reduction from 177/115 to 125/80 mmHg in the same day postoperatively, and stabilized to be within the normal range. The BP level of the patient remained within the normal range subsequent to a 6-month follow-up. Pathological analysis revealed reninoma on the left kidney. The present study aimed to provide information for radiologists who may encounter this type of benign tumor in the future, which exhibits elevated BP levels. IntroductionReninomas, or renal juxtaglomerular cell tumors, develop within the juxtaglomerular apparatus through the evolution of small artery smooth muscle cells. These tumor cells produce excessive amounts of renin that results in severe hypertension with hypokalemia and hyperaldosteronism, through the activity of the renin-angiotensin aldosterone system (1). It is a rare form of secondary hypertension. Removing the reninoma results in the conversion of increased blood pressure to normal blood pressure (2). Therefore, perioperative hemodynamic management is important in patients who undergo surgery for the removal of a reninoma.Adrenal adenoma is a benign neoplasm, which is derived from cells of the adrenal cortex, and may be functionally active or nonfunctional (3). Functional adrenal adenoma is able to cause aldosteronism or Cushing's syndrome. Primary aldosteronism (PA) is characterized by autonomous aldosterone production, which is a cause of secondary hypertension (4). Evidence has developed over the past decades and led to the recognition that autonomous adrenal aldosterone production, termed primary aldosteronism, is common in hypertensive patients. Between 5 and 13% of patients with hypertension have primary aldosteronism (5).The present study reported a rare case of reninoma coexisting with an adrenal adenoma in a young female with secondary hypertension during pregnancy. Case reportA 2.5-cm mass was detected on the right adrenal gland of a 31-year-old pregnant female with hypertension in her 33rd gestational week by an ultrasound scan. The patient presented with a personal history of elevated blood pressure (BP) for several months prior to conception, and exhibited a family history of hypertension. There were no other abnormalities found by the ultrasounds of the adrenal gland and the renal arter...

show abstract

Section: Discussionmentioning

confidence: 79%

Reninoma coexisting with adrenal adenoma during pregnancy: A case report

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Mismanagement often leads to premature delivery, abortion, or stillbirth[ 19 ]. In the case reported by Ohashi et al [ 20 ], undiagnosed JGCT caused uncontrolled hypertension. The patient had been diagnosed with pre-eclampsia before termination of pregnancy, and pregnancy was terminated at 25 wk due to congestive heart failure and acute kidney injury.…”

Section: Discussionmentioning

confidence: 99%

“…The patient had been diagnosed with pre-eclampsia before termination of pregnancy, and pregnancy was terminated at 25 wk due to congestive heart failure and acute kidney injury. Further examination after termination of pregnancy revealed a tumor in the left kidney, which was confirmed as JGCT on pathological examination after surgical resection[ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Pregnancy complicated by juxtaglomerular cell tumor of the kidney: A case report

Fu¹,

Deng²,

Wang³

et al. 2023

World J Clin Cases

View full text Add to dashboard Cite

BACKGROUND Juxtaglomerular cell tumor (JGCT) of the kidney, also known as reninoma, is a rare renal tumor that typically clinically manifests as hypertension, hypokalemia, high renin, and high aldosterone. It is a cause of secondary hypertension. Pregnancy with JGCT is rarer and easily misdiagnosed as pregnancy-induced hypertension, thus affecting treatment. CASE SUMMARY A 28-year-old woman presented in early pregnancy with hypertension (blood pressure of 229/159 mmHg), nausea, and occasional dizziness and headache. The patient was diagnosed with pregnancy-induced hypertension, and no relief was found after symptomatic treatment; hence, the pregnancy was terminated by artificial abortion. Her blood pressure remained high following termination of pregnancy. Blood tests suggested hypokalemia (2.997 mmol/L), blood aldosterone measured 613 ng/L, and computed tomography urography showed a tumor in the right kidney. Therefore, laparoscopic partial nephrectomy was performed. After surgery, the patient’s blood pressure returned to normal, and blood potassium, aldosterone, and renin normalized. Postoperative pathological examination revealed JGCT. After long-term follow-up, the patient became pregnant again 6 mo after surgery. No hypertension occurred during pregnancy, and the patient delivered a healthy female neonate. CONCLUSION Patients with pregnancy complicated by JGCT are difficult to diagnose. Herein, we advise surgeons on proper handling of such situations.

show abstract

“…JGCT is a rare disease which presents renal mass by CT, and about 100 cases have been reported until now 5 . Since JGCT is more prevalent in young female adults, 6 several cases during pregnancy have been reported as well 7 . Most of the JGCT causes oversecretion of renin and as a result of that the patients present with hyperaldosteronism symptom such as hypertension and hypokalemia 8 .…”

Section: Discussionmentioning

confidence: 99%

Juxtaglomerular cell tumor diagnosed preoperatively by renal tumor biopsy

Ueda¹,

Morinaga²,

Inoue

et al. 2021

IJU Case Reports

View full text Add to dashboard Cite

Introduction Diagnosis of small renal tumor from imaging analysis is limited. We report a case of juxtaglomerular cell tumor diagnosed preoperatively by renal tumor biopsy. Case presentation A 17‐year‐old male was urgently hospitalized for acute‐onset congestive heart failure. Radiographic findings revealed a 2‐cm mass lesion, and on renal biopsy, a juxtaglomerular cell tumor was suspected. The juxtaglomerular cell tumor was resected by laparoscopic partial nephrectomy, on suspicion of causing the heart failure. The patient’s clinical symptoms improved drastically postoperatively. Conclusion Biopsy may be a promising option for preoperative diagnosis of juxtaglomerular cell tumors.

show abstract

Focal Segmental Glomerulosclerosis Secondary to Juxtaglomerular Cell Tumor during Pregnancy: A Case Report

Cited by 9 publications

References 12 publications

Reninoma coexisting with adrenal adenoma during pregnancy: A case report

Reninoma coexisting with adrenal adenoma during pregnancy: A case report

Pregnancy complicated by juxtaglomerular cell tumor of the kidney: A case report

Juxtaglomerular cell tumor diagnosed preoperatively by renal tumor biopsy

Contact Info

Product

Resources

About