Fu X, Deng G, Wang K, Shao C, Xie LP. Pregnancy complicated by juxtaglomerular cell tumor of the kidney: A case report. World J Clin Cases 2023; 11(11): 2541-2548 [PMID: 37123308 DOI: 10.12998/wjcc.v11.i11.2541]
Corresponding Author of This Article
Li-Ping Xie, PhD, Director, Professor, Surgeon, Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou 310003, Zhejiang Province, China. xielp@zju.edu.cn
Research Domain of This Article
Urology & Nephrology
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. Apr 16, 2023; 11(11): 2541-2548 Published online Apr 16, 2023. doi: 10.12998/wjcc.v11.i11.2541
Pregnancy complicated by juxtaglomerular cell tumor of the kidney: A case report
Xian Fu, Gang Deng, Kai Wang, Chang Shao, Li-Ping Xie
Xian Fu, Gang Deng, Kai Wang, Department of Urology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Chang Shao, Department of Pathology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Li-Ping Xie, Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Fu X, Wang K, and Deng G performed partial nephrectomy; Fu X and Wang K collected the clinical data and compared the current case with the literature; Fu X and Shao C collected the images; Fu X wrote the manuscript; Xie LP critically revised the manuscript; all authors read and approved the final manuscript.
Supported byMedical and Health Technology Project of Hangzhou, No. A20220540.
Informed consent statement: Informed consent was obtained in both written and verbal format from the patient to publish this case report and any accompanying images.
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: Li-Ping Xie, PhD, Director, Professor, Surgeon, Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou 310003, Zhejiang Province, China. xielp@zju.edu.cn
Received: December 26, 2022 Peer-review started: December 26, 2022 First decision: January 12, 2023 Revised: January 27, 2023 Accepted: March 17, 2023 Article in press: March 17, 2023 Published online: April 16, 2023 Processing time: 100 Days and 21.8 Hours
Abstract
BACKGROUND
Juxtaglomerular cell tumor (JGCT) of the kidney, also known as reninoma, is a rare renal tumor that typically clinically manifests as hypertension, hypokalemia, high renin, and high aldosterone. It is a cause of secondary hypertension. Pregnancy with JGCT is rarer and easily misdiagnosed as pregnancy-induced hypertension, thus affecting treatment.
CASE SUMMARY
A 28-year-old woman presented in early pregnancy with hypertension (blood pressure of 229/159 mmHg), nausea, and occasional dizziness and headache. The patient was diagnosed with pregnancy-induced hypertension, and no relief was found after symptomatic treatment; hence, the pregnancy was terminated by artificial abortion. Her blood pressure remained high following termination of pregnancy. Blood tests suggested hypokalemia (2.997 mmol/L), blood aldosterone measured 613 ng/L, and computed tomography urography showed a tumor in the right kidney. Therefore, laparoscopic partial nephrectomy was performed. After surgery, the patient’s blood pressure returned to normal, and blood potassium, aldosterone, and renin normalized. Postoperative pathological examination revealed JGCT. After long-term follow-up, the patient became pregnant again 6 mo after surgery. No hypertension occurred during pregnancy, and the patient delivered a healthy female neonate.
CONCLUSION
Patients with pregnancy complicated by JGCT are difficult to diagnose. Herein, we advise surgeons on proper handling of such situations.
Core Tip: Juxtaglomerular cell tumor (JGCT) is a rare endocrine tumor of the kidney. Typical JGCTs are characterized by high serum renin, high aldosterone secretion, severe hypertension, and severe hypokalemia, known as the “three high and one low” phenomenon. The mainstream treatment is surgery. We report an even rarer case of pregnancy complicated with JGCT, who was misdiagnosed with pregnancy-induced hypertension in a primary hospital, and the pregnancy was terminated artificially due to poor response to conservative treatment. The patient was admitted to our hospital for further treatment because her blood pressure remained high after termination of pregnancy and she was diagnosed with JGCT. The patient recovered well after surgery to remove the tumor. In this article, the case is analyzed retrospectively in the context of the literature in an attempt to explore the diagnosis, treatment, and prognosis of this rare disease.
