Korean J Pediatr.  2017 Aug;60(8):266-271. 10.3345/kjp.2017.60.8.266.

Clinical characteristics of hypertensive encephalopathy in pediatric patients

Affiliations
  • 1Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea. sunjun@jbnu.ac.kr
  • 2Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea.

Abstract

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±36.9 mmHg) was higher than that of the nonrenal group (137.1±11.1 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.

Keyword

Child; Hypertension; Encephalopathy; Magnetic resonance imaging

MeSH Terms

Acute Kidney Injury
Blood Pressure
Brain
Brain Diseases
Child
Glomerulonephritis
Humans
Hypertension
Hypertensive Encephalopathy*
Jeollabuk-do
Leukemia, Promyelocytic, Acute
Lupus Nephritis
Magnetic Resonance Imaging
Neurologic Manifestations
Pheochromocytoma
Posterior Leukoencephalopathy Syndrome
Renal Artery Obstruction
Retrospective Studies
Seizures
Thyrotoxicosis
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