Wilms tumor and cardiomyopathy.
St Anna Children's Hospital, Vienna, Austria.Medical and Pediatric Oncology 01/2004; 41(6):574. DOI:10.1002/mpo.10398
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ABSTRACT: 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.Medical and Pediatric Oncology 02/1986; 14(1):63-6.
Article: Wilms' tumor and hypertension.[show abstract] [hide abstract]
ABSTRACT: A high percentage of Wilms' tumor patients have hypertension associated with the tumor. Of 46 patients with complete blood pressure studies, 29 (63%) had systolic or systolic-diastolic elevations.Hypertension seems to be the result of increased renin production secondary to renal ischemia produced by the mechanical effects of the tumor. It did not, in itself, have any bearing on survival; metastatic disease was the principal factor affecting ultimate prognosis. Removal of the kidney returned blood pressure to normal in all cases, even when metastatic disease remained.Journal of Pediatric Surgery 01/1972; 7(5):573-6. · 1.38 Impact Factor
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ABSTRACT: Two infants with renal tumors and associated hypertension are presented. By using an antibody to purified human renal renin, the sites of renin production were localized immunohistochemically in each tumor. The first case was a 9-month-old girl with Beckwith-Wiedemann syndrome. She presented with bilateral renal masses and hypertension (140/90 mm Hg). Following a left nephrectomy and chemotherapy and radiotherapy, her BP returned to normal. Her tumor was a Wilms' tumor of favorable histology, composed predominantly of glomeruloid structures. Renin was localized within a part of these neoplastic glomeruloid bodies. We therefore designated this as a Wilms' tumor with glomeruloid differentiation having primary reninism. The second case was a 24-day-old girl with hypertension (140/70 mm Hg). A renal tumor was found and successfully removed. Her BP returned to normal. The tumor was histologically confirmed as a congenital mesoblastic nephroma. By indirect immunoperoxidase staining, renin was localized only in the hypertrophied juxtaglomerular cells adjacent to the residual glomeruli entrapped by the tumor. None was seen in the tumor cells. We concluded that this was a case of secondary reninism--a case of hypertension secondary to the local ischemia at the entrapped glomeruli.Journal of Pediatric Surgery 06/1988; 23(5):403-9. · 1.38 Impact Factor
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