FROM STATUS EPILEPTICUS TO HYPERTENSIVE EMERGENCY: THE ONSET OF A PHEOCHROMOCYTOMA IN A PEDIATRIC PATIENT – A CASE REPORT
DOI:
https://doi.org/10.56754/0718-9958.2025.255Keywords:
Pheochromocytoma, Hypertension, Headache, Seizures, ChildrenAbstract
INTRODUCTION: Pheochromocytomas are adrenal medulla tumors that secrete catecholamines. Their occurrence in children is uncommon, accounting for approximately 20% of all cases. They typically present with headache, diaphoresis, palpitations, and arterial hypertension. CASE PRESENTATION: We report the case of an 8 year old school-aged child who presented with persistent, refractory headache. The clinical course progressed to status epilepticus and a hypertensive emergency. Diagnosis was confirmed through biochemical and imaging studies, and the condition was resolved with surgical intervention. DISCUSSION: The clinical evaluation of headache and hypertension in pediatric patients should focus on identifying secondary causes. The younger the patient, the greater the likelihood of secondary hypertension. In school-aged children, pheochromocytoma is a rare but important differential diagnosis. Diagnosis relies on biochemical testing and anatomical imaging. Surgical resection is the definitive treatment. CONCLUSION: The combination of headache and hypertension should be considered a red flag, and routine blood pressure measurement in pediatric emergency settings should be standard clinical practice.
References
Baglioni V, Orecchio S, Esposito D, Faedda N, Natalucci G, Guidetti V. Tension-type headache in children and adolescents. Life (Basel) [Internet]. 2023;13(3). Disponible en: http://dx.doi.org/10.3390/life13030825
Viera AJ, Antono B. Acute headache in adults: A diagnostic approach. Am Fam Physician. 2022;106(3):260–8.
Do TP, Remmers A, Schytz HW, Schankin C, Nelson SE, Obermann M, et al. Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list: SNNOOP10 list. Neurology [Internet]. 2019;92(3):134–44. Disponible en: http://dx.doi.org/10.1212/WNL.0000000000006697
Ministerio de salud. (2023). orientación técnica para la pesquisa, diagnóstico y manejo de la hipertensión arterial en la infancia y adolescencia. gobierno de chile.
Oleaga A, Goñi F. Feocromocitoma: actualización diagnóstica y terapéutica. Endocrinología y Nutrición [Internet]. 2008 May 1;55(5):202–16. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S1575092208706697
Mateo-Gavira I, Baena-Nieto G, García-Doncel LG, Torres-Barea IM. Actualización sobre el manejo diagnóstico y terapéutico del feocromocitoma y el paraganglioma. Medicine - Programa de Formación Médica Continuada Acreditado [Internet]. 2020 Oct 1;13(19):1083–93. Disponible en: https://www.sciencedirect.com/science/article/pii/S0304541220302560
De Simone G, Mancusi C, Hanssen H, Genovesi S, Lurbe E, Parati G, et al. Hypertension in children and adolescents. European Heart Journal. 2022 Julio 8;43(35):3290–301.
Salas P, Gonzalez C, Carrillo D, Bolte L, Aglony M, Peredo S, et al. Hipertensión arterial en la infancia. Recomendaciones para su diagnóstico y tratamiento. Parte 1. Rama de Nefrología Infantil, Sociedad Chilena de Pediatría. Andes Pediatrica [Internet]. 2019 [citado el 12 de Mayo 2025];90(2):209–16. Disponible en: https://andespediatrica.cl/index.php/rchped/article/view/1005
Achote E, Arroyo Ripoll OF, Araujo-Castro M. Update on the diagnosis of the pheochromocytoma. Hipertensión y Riesgo Vascular. 2025 Jan;42(1):43–51.
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Copyright (c) 2025 Sebastián Ignacio Villalobos Garrido, Antonia Gabriela Alonzo Leal , Gustavo Orlando Gonzalez Solis, Antonia Fernanda Soto Besamat
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