Malignant arterial hypertension in a child with nonspecific aortoarteritis

Злокачественная артериальная гипертензия у ребенка с неспецифическим аортоартериитом
Maitbasova R.S. Nurgaliyeva Z.Zh. Erzhanova G.E. Onlasynov A.K. Abekenov B.D. Abuov G.T.
2024 Eco-Vector LLC

Russian Family Doctor
2024 #28 Issue 3 66 - 73 pp.

The article presents a clinical case of malignant renovascular hypertension in a child, resulting from non-specific aortoarteritis. The disease initially manifested with abdominal pain and convulsions, leading to hospitalization. During the hospital stay, blood pressure readings were elevated to 180/100 mmHg and higher. Over the course of a year, the patient underwent pathogenetic (immunosuppressive), combined (triple) antihypertensive treatment, and symptomatic therapy. Due to the malignant nature of the hypertension, progression of organ damage, a high risk of complications and mortality, and the ineffectiveness of conservative treatment, surgical interventions were performed. The first stage involved polyposition abdominal aortography and stent-graft implantation in the abdominal aorta. Despite restored blood flow in the abdominal aorta, blood pressure remained elevated over the following three months, even with ongoing antihypertensive therapy. As a result, a nephrectomy was performed at the second stage. Postoperatively, the patient’s blood pressure significantly decreased to 130/90–120/80 mmHg. Antihypertensive therapy was continued to reach lower target blood pressure values. Non-specific aortoarteritis remains a prognostically unfavorable condition, even after reconstructive surgery, owning to its autoimmune nature, which suggests ongoing arterial inflammation even during clinical remission. This necessitates lifelong monitoring by a rheumatologist. All rights reserved

child , hypertension , nephrectomy , non-specific aortoarteritis , stent-graft implantation

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Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Kazakhstan
Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan

Scientific Center of Pediatrics and Pediatric Surgery
Asfendiyarov Kazakh National Medical University

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