Reninoma: An Uncommon Cause of Renin-Mediated Hypertension

Trnka, Peter; Orellana, Luisa; Walsh, Mark; Pool, Louis; Borzi, Peter

doi:10.3389/fped.2014.00089

Cited by 40 publications

(40 citation statements)

References 26 publications

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“…No entanto, este é um procedimento invasivo, com elevada taxa de falsos negativos, justificado pela natureza cortical e drenagem venosa pericapsular da maioria dos reninomas descritos. 9,10 O diagnóstico histológico também é desafiante, atendendo ao escasso número de casos publicados, sendo confirmado pela positividade da renina no citoplasma, embora esta positividade possa também ser observada no CCR, nefroblastoma, ou oncocitoma renal. O estudo imunohistoquímico é essencial para excluir os diagnósticos acima referidos, sendo que, tal como neste caso, a maioria das células neoplásicas de reninoma são difusamente imunorreativas à vimentina e ao CD34.…”

Section: Discussionunclassified

“…11,12 A ressecção cirúrgica do tumor, com nefrectomia parcial, é o tratamento de escolha e leva à normalização da TA. 4,6,9,13 Atendendo à raridade desta entidade, não há atualmente evidência que suporte recomendações específicas para o seguimento destes doentes. Em todos os casos reportados é sugerida vigilância clínica e laboratorial após a cirurgia.…”

Section: Discussionunclassified

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Reninoma: Uma Causa Rara de Hipertensão Endócrina

et al. 2020

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Juxtaglomerular tumours are rare causes of secondary hypertension. They typically present with difficult-to-manage hypertension, hypokalemia, hyperreninemia and secondary hyperaldosteronism. The authors describe a clinical case of a 45 years old female patient, with personal history of difficult-to-manage hypertension and hypokalemia since age 35, medicated with four types of anti-hypertensive agents. An analytical study was performed, which revealed secondary hyperaldosteronism [aldosterone 44.3 ng/dL (4 – 28 ng/dL), renin > 1000 mIU/mL (4.4 – 46.2 mIU/mL)]. Abdominal computed tomography scan identified a heterogeneous nodule located in the middle third of the right kidney, with 3.7 cm. Partial nephrectomy was performed and histological analysis confirmed the diagnosis of reninoma. After surgery, the patient had normal levels of aldosterone (9.2 ng/dL) and renin (1.20 mIU/mL), as well as normal blood pressure. The authors want to highlight this potentially curable cause of endocrine hypertension. Surgical resection is the treatment of choice and leads to normalization of blood pressure.

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Section: Discussionunclassified

Reninoma: Uma Causa Rara de Hipertensão Endócrina

et al. 2020

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“…Excess renin by renin vein sampling can be used for lateralization of the tumor. [12] Acromegaly Excess growth hormone can produce hypertension.…”

Section: Reninomamentioning

confidence: 99%

Rare and unusual causes of hypertension

Mahilmaran¹

2018

johtn

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In patients in early childhood, secondary causes are underlying in 70-85% of cases. [2] The most common causes are renal causes. Reflux AbstractBackground: Hypertension in most cases is primary, the exact etiology not known but there may be risk factors such as salt excess, obesity, lack of physical activity, genetic factors, metabolic syndrome, and diabetes. However, there exists a subgroup of patients with hypertension with underlying etiology, referred to as secondary hypertension, and constitutes about 5-10% of patients with hypertension. The importance of diagnosis of the secondary causes of hypertension is to detect a potentially reversible etiology. Some of these causes are rare and unless looked for, can be easily missed. Methods: A review of age-specific causes, approach, rare diseases of the aorta, endocrine, renal, iatrogenic, and substance abuse have been discussed. The importance of suspecting unusual causes in patients with uncontrolled hypertension, hypertension in the young, in the presence of target organ damage is emphasized. Case reports of rare cases have been included. Conclusion: A systematic approach and knowledge of various rare causes will help suspect and lead to the correct diagnosis in many cases of secondary rare causes of hypertension. It gives a unique opportunity to cure hypertension in some cases and if the underlying cause is undiagnosed may result in morbidity and even prove fatal in some cases. R e v i e w A r t i c l eRare and unusual causes of hypertension Mahilmaran

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“…Albeit AT1R is expressed in human, bovine, and ovine fasciculata cells ( 65 – 67 ) data whether AII alone stimulates cortisol secretion are conflicting ( 62 , 68 – 70 ). Rat fasciculata cells do not express detectable amounts of AT1R ( 71 – 73 ) [but see Ref.…”

Section: Classical Signaling Pathways In the Adrenal Cortexmentioning

confidence: 99%

Signaling Interactions in the Adrenal Cortex

2016

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The major physiological stimuli of aldosterone secretion are angiotensin II (AII) and extracellular K+, whereas cortisol production is primarily regulated by corticotropin (ACTH) in fasciculata cells. AII triggers Ca2+ release from internal stores that is followed by store-operated and voltage-dependent Ca2+ entry, whereas K+-evoked depolarization activates voltage-dependent Ca2+ channels. ACTH acts primarily through the formation of cAMP and subsequent protein phosphorylation by protein kinase A. Both Ca2+ and cAMP facilitate the transfer of cholesterol to mitochondrial inner membrane. The cytosolic Ca2+ signal is transferred into the mitochondrial matrix and enhances pyridine nucleotide reduction. Increased formation of NADH results in increased ATP production, whereas that of NADPH supports steroid production. In reality, the control of adrenocortical function is a lot more sophisticated with second messengers crosstalking and mutually modifying each other’s pathways. Cytosolic Ca2+ and cGMP are both capable of modifying cAMP metabolism, while cAMP may enhance Ca2+ release and voltage-activated Ca2+ channel activity. Besides, mitochondrial Ca2+ signal brings about cAMP formation within the organelle and this further enhances aldosterone production. Maintained aldosterone and cortisol secretion are optimized by the concurrent actions of Ca2+ and cAMP, as exemplified by the apparent synergism of Ca2+ influx (inducing cAMP formation) and Ca2+ release during response to AII. Thus, cross-actions of parallel signal transducing pathways are not mere intracellular curiosities but rather substantial phenomena, which fine-tune the biological response. Our review focuses on these functionally relevant interactions between the Ca2+ and the cyclic nucleotide signal transducing pathways hitherto described in the adrenal cortex.

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Reninoma: An Uncommon Cause of Renin-Mediated Hypertension

Cited by 40 publications

References 26 publications

Reninoma: Uma Causa Rara de Hipertensão Endócrina

Reninoma: Uma Causa Rara de Hipertensão Endócrina

Rare and unusual causes of hypertension

Signaling Interactions in the Adrenal Cortex

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