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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Congestive heart failure is an unusual complication of the hyperreninemia of Wilms' tumors. Cases with bilateral tumors present a difficult management problem. This is a report of the successful medical management of a child with congestive heart failure secondary to hyperreninemia from bilateral Wilms' tumor. Hypertension and hyperreninemia were extensively documented. Their etiologic relation to the congestive heart failure was supported by the patient's improved cardiac function following specific renin-angiotensin blockade. With unilateral tumors, surgical excision corrects the hypertension; however, with large bilateral tumors, excision is out of the question. A unique feature of this case is the ability to control the blood pressure with saralasin. With subsequent antitumor therapy, renin concentrations decreased proportional to tumor size, and renin angiotensin blocking therapy could be discontinued.
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PMID:Congestive heart failure, hypertension, and hyperreninemia in bilateral Wilms' tumor: successful medical management. 300 17

Thirty cases of Wilms' tumor who had been treated at the Ramathibodi Hospital from January 1970 to December 1982 were analysed retrospectively. There were 14 boys and 16 girls, aged 6 months to 7 years (mean age was 2 years). The right kidney was involved in 12 cases, the left side involvement in 18 cases. Other than the abdominal mass, the common signs and symptoms were hematuria (30%) and hypertension (13.3%). The congenital anomalies were found in 2 cases. There was an increase in VMA in three of the six cases determined for VMA:creatine ratio and VMA in 24 hours urine. Seven cases (23.3%) had nephrectomy done in other hospitals. Ninety percent of the patients came in with the stage II-IV, only 10% had stage I. The treatment consisted of surgery, radiation therapy, actinomycin-D, vincristine and adriamycin. Eight patients (26.6%) were lost to follow-up. The cure rate in stage II, III and IV were 71.4%, 50% and 29% respectively. The serious surgical complications include a case of shock due to excessive bleeding and another case of sudden death during the operation due to the tumor emboli from the inferior vena cava to the main pulmonary and both bronchial arteries.
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PMID:Wilms' tumor: analysis of thirty cases. 301 93

Gestational risk factors for Wilms' tumor were investigated in a pair-matched case-control study. Cases who were under 15 years of age at diagnosis during 1970-1983 were identified through the registries of the three main hospitals treating childhood cancer in the greater Philadelphia area. Controls were selected by random digit dialing and were matched to cases on race, birth date, and telephone area code and exchange. Because of a low participation rate among nonwhites, results are reported only for the 88 white matched pairs whose parents were interviewed by telephone. Of the hypothesized risk factors, maternal use of hair-coloring products in the year prior to the index child's birth (odds ratio, 3.6; P = 0.003) and hypertension or fluid retention during pregnancy (odds ratio, 5.0, P = 0.01) were significantly associated with increased risk of Wilms' tumor. Use of hair-coloring products was strongly associated with cases in which Wilms' tumor was diagnosed before 2 years of age (odds ratio, 15; P = 0.001). For two other gestational factors, tea drinking and vaginal infection, the odds ratios were significantly elevated for all cases and the effects were concentrated among the nongenetic cases. Bilateral cases had a significantly higher mean birth weight than did their controls. Older maternal age was significantly associated with the genetic form of Wilms' tumor. Adjustment for possible confounders and consideration of the time interval between the index pregnancy and the interview did not substantially alter the findings.
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PMID:Gestational risk factors for Wilms' tumor: results of a case-control study. 303 18

We report on a developmental malformation of the lung and kidney which has not been previously described and which we have chosen to call "cystic hamartomata of the lung and kidney" to emphasize the non-malignant nature of these lesions. We also confirm a previous case report by Weinberg and Zumwalt [1977] as a different distinct disorder that results in a multifocal cystic hamartomata of the lung with associated marked parenchymal overgrowth of the kidney (the Weinberg-Zumwalt syndrome). These cases represent a spectrum of abnormal morphogenesis affecting both kidney and lung. Patients 1 and 2 presented during infancy with abdominal masses and hypertension due to bilateral multilocular cysts of the kidney with associated hamartomatous pulmonary cysts; patient 2 also had one area of cellular mesoblastic nephroma. Patient 3 demonstrated markedly hyperplastic renomegaly with medullary dysplasia in association with bilateral cystic hamartomata of the lungs. During the fifth week of gestation, the ureteric bud invades the unsegmented mesoderm that becomes the metanephric system, and the lung bud invades the splanchic mesoderm, which provides the stimulus for its growth. We suggest that the predominant pattern of a congenital kidney or lung hamartoma might reflect the timing of a prenatal neoplastic event affecting these developmental processes.
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PMID:Cystic hamartomata of lung and kidney: a spectrum of developmental abnormalities. 360 6

Unilateral parenchymatous kidney disease associated with high blood pressure represents a potentially curable form of hypertension. Surgery may normalize blood pressure in a substantial number of these patients. Curable renal parenchymatous hypertension includes unilateral tubulointerstitial kidney diseases such as chronic pyelonephritis, reflux nephropathy, segmental hypoplasia and radiation nephritis, hydronephrosis, simple renal cysts, traumatic kidney lesions and renal tumors associated with high blood pressure. Renal ischemia and in turn activation of the renin angiotensin system is involved in the pathogenesis of hypertension in most of these patients. In patients with unilateral kidney disease and hypertension, both an operative and a medical therapeutic approach have a high success rate. Good candidates for nephrectomy are young patients with severe hypertension, strict unilateral disease, normal plasma creatinine levels and minimal function of the involved kidney. In unilateral hydronephrosis reconstructive surgery or nephrectomy may cure or improve hypertension in the vast majority of the patients. Surgically correctable hypertension has also been reported in some patients with large renal cysts and renal tumors (hemangiopericytoma, Wilm's tumor, hypernephroma, renal pelvic tumor).
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PMID:Curable renal parenchymatous hypertension: current diagnosis and management. 390 29

The authors report the case of a very unusual kidney tumour discovered in a newborn infant known to have abnormal dense and cystic structures in both kidneys already during the intra-uterine period as a result of antenatal echotomography. Severe hypertension developed on the 10th day of life, accompanied by the hypersecretion of angiotensin. Right nephrectomy of the multicystic and poorly functioning kidney resulted in the normalisation of blood pressure. A left lower polar nephrectomy for tumour finally gave a good result, with three years' follow-up. Histology of the right kidney revealed a nephroblastoma with cystic dysplasia, areas of nephroblastomatosis and the secretion of alpha-foetoprotein, in the nephroblastomatous tubular structures. On the left, there was a nephroblastoma associated with areas of nephroblastomatosis.
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PMID:[An unusual renal tumor, associating nephroblastoma, nephroblastomatosis, teratoma, and cystic dysplasia with arterial hypertension and secretion of alpha-fetoprotein]. 620 2

A 4-yr-old boy with Wilms' tumor, hypertension, and hyperreninemia is presented. Three times as much renin was extracted from tumor tissue as from adjacent renal parenchyma, suggesting that the tumor itself was the primary source of the renin and cause of the hypertension. Other reported cases of hypertension and increased renin production with Wilms' tumor are reviewed. Hypertension is a very frequent finding in patients presenting with Wilms' tumor. The possibility that many of these neoplasms may be found to hypersecrete renin if properly investigated is discussed.
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PMID:Renin producing Wilms' tumor. 626 73

We report the radiographic and clinical findings of five infants and children who had the combination of male pseudohermaphroditism, progressive nephritis, and Wilms tumor. The components of this syndrome are so striking that the radiologist can often suggest the diagnosis months to years before all three components are apparent, if proteinuria, hypertension, or an abdominal mass develop in any child with male pseudohermaphroditism. Since the progressive renal failure probably can be managed by dialysis or renal transplantation in some cases, prompt recognition and treatment of the Wilms tumor may permit the child to live a long and relatively normal life.
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PMID:The Drash syndrome: male pseudohermaphroditism, nephritis, and Wilms tumor. 627 Jul 28

A nephroblastoma was diagnosed in a 6-month-old, male rat which died unexpectedly. The right kidney was replaced by a large, white, irregularly shaped mass. Microscopically, the mass consisted of an embryonic blastema showing epithelial differentiation into immature tubules and glomeruloid structures. An aortic aneurysm and aortic rupture were present within the thoracic cavity. It was suspected that the aortic rupture was secondary to hypertension mediated through the renin-angiotensin system.
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PMID:Nephroblastoma with associated aortic rupture in a rat. 628 75

Mesoblastic nephroma is a distinctive pathologic renal tumor with unique clinical, therapeutic, and prognostic patterns. This report reviews 51 patients (2.8% of 1905 patients submitted to NWTS with renal tumors) with this diagnosis from the NWTS contrasting this disease entity with Wilms' tumor. There were 33 males and 18 females, predominantly term babies born after uncomplicated pregnancies. The mean age at tumor excision was 3.44 +/- 0.6 mo (one child 9 yr). A palpable mass was the predominant presentation in 48 patients and in addition hematuria (9), hypertension (2), vomiting (3), and jaundice (1) were noteworthy. Diagnostic studies included IVP (49 positive, 2 negative) and ultrasound (15 positive, 1 negative). Adequate operative excision was achieved in 43 of 51 patients while 8 children had local extension and 10 had tumor spillage. Operation alone (23), predominantly since 1978, surgery plus chemotherapy (24), prior to 1978, and surgery, chemotherapy, and radiation therapy (4), prior to 1976, were the modes of therapy. The follow-up ranges from 4 mo to 11.5 yr. Survival was excellent; 50 patients survive (98%), only 1 dying of sepsis. These data suggest that mesoblastic nephroma contrasts with Wilms' tumor in that it occurs in a younger age group, has a benign biologic behavior, and a more favorable outcome. Aggressive multimodal treatment though utilized in the early years of the study is not essential to achieve this outcome.
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PMID:Therapy and outcome in 51 children with mesoblastic nephroma: a report of the National Wilms' Tumor Study. 629 97


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