Wei JH, Yan HL. Primary hypertension in a postoperative paraganglioma patient: A case report. World J Clin Cases 2022; 10(22): 7931-7935 [PMID: 36158477 DOI: 10.12998/wjcc.v10.i22.7931]
Corresponding Author of This Article
Hai-Li Yan, Doctor, Department of Vasculocardiology, Sanmenxia Central Hospital Middle, Western Xiaoshan Road, Hubin District, Sanmenxia 472000, Henan Province, China. lbyanhaili@163.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 6, 2022; 10(22): 7931-7935 Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.7931
Primary hypertension in a postoperative paraganglioma patient: A case report
Jian-Hui Wei, Hai-Li Yan
Jian-Hui Wei, Hai-Li Yan, Department of Vasculocardiology, Sanmenxia Central Hospital, Sanmenxia 472000, Henan Province, China
Author contributions: Wei JH conceived the idea, designed the experiments, and interpreted the data; Wei JH and Yan HL performed the experiments, analyzed the data, and wrote the manuscript; all authors reviewed and approved the manuscript.
Supported bythe Key Project of Medical Science and Technology of Henan Province, No. LHGJ20200923; and the Sanmenxia Science and Technology Bureau Science and Technology Development Program Science and Technology Benefit the People Project, No. 2019060336.
Informed consent statement: All experiments were performed in compliance with the ethical standards formulated in the Helsinki Declaration of 1964. The study was approved by the Sanmenxia Central Hospital. Informed consent was obtained from the patient.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist(2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Li Yan, Doctor, Department of Vasculocardiology, Sanmenxia Central Hospital Middle, Western Xiaoshan Road, Hubin District, Sanmenxia 472000, Henan Province, China. lbyanhaili@163.com
Received: November 3, 2021 Peer-review started: November 3, 2021 First decision: November 19, 2021 Revised: December 15, 2021 Accepted: June 27, 2022 Article in press: June 27, 2022 Published online: August 6, 2022 Processing time: 260 Days and 16.3 Hours
Abstract
BACKGROUND
Primary hypertension is a common clinical disease. Pheochromocytoma and paraganglioma is a rare cause of secondary hypertension. The diagnosis of the latter is still difficult, and the relationship between the two is not clear. The successful diagnosis of this case confirmed that standardized etiological investigation of secondary hypertension is necessary, contributes to the accurate diagnosis of rare diseases, and is conducive to the formulation or optimization of treatment plans. It shows an example of the coexistence of primary hypertension and secondary hypertension.
CASE SUMMARY
The patient was a 54-year-old male and was hospitalized with high blood pressure for 4 years. The patient’s blood pressure was measured at 150/100 mmHg during physical examination 4 years ago and had no paroxysmal or persistent elevated blood pressure, no typical triad of headache, palpitation, and sweating, without postural hypotension. After taking nifedipine sustained release tablets intermittently, the blood pressure did not meet the standard. Physical examination revealed blood pressure of 180/120 mmHg. There was no abnormality in cardiopulmonary and abdominal examination. The results of blood and/or urinary catecholamines/metanephrine and normetanephrine before and after operation were normal. Fundus examination revealed retinal arteriosclerosis in both eyes. There was a history of paraganglioma diagnosed by pathology after retroperitoneal tumor resection, a family history of hypertension, and a history of passive smoking. The clinical diagnosis was subclinical paraganglioma, primary hypertension, and hypertensive fundus lesions. The patient’s blood pressure was regulated, blood lipid was reduced, and anti-inflammatory, and symptomatic support were given. After treatment, the blood pressure was stable and up to standard without discomfort symptoms.
CONCLUSION
Subclinical paraganglioma and primary hypertension can coexist. The holistic thinking in clinical practice is helpful to the early diagnosis of rare diseases.
Core Tip: Pheochromocytoma and paraganglioma (PPGL) is a rare cause of secondary hypertension, and early and accurate diagnosis is still facing challenges. A case of subclinical paraganglioma (PGL) complicated with essential hypertension was analyzed retrospectively. A typical and subclinical pheochromocytoma and PGL should be paid more attention due to the lack of clinical features. At the same time, standardized etiological investigation of secondary hypertension is also an indispensable part of an accurate diagnosis. Clinical practice has proven that subclinical PGL and essential hypertension are two independent diseases that can coexist. After reviewing the literature, it is considered that genetic susceptibility is the same pathogenic factor.
