Why the study?
Hypertension in younger children is usually secondary to various disorders, requiring identification of the underlying cause.
Does a captopril DMSA scan help identify the cause of severe hypertension in a pediatric patient when conventional imaging is normal?
Does a captopril DMSA scan help identify the cause of severe hypertension in a pediatric patient when conventional imaging is normal?
A captopril DMSA scan can be a valuable diagnostic tool for localizing small intrarenal artery branch stenoses in pediatric patients with severe renovascular hypertension when standard imaging modalities are unrevealing.
Hypertension in younger children is usually secondary to various disorders. A previously healthy 5-year-old girl was diagnosed with stage 2 hypertension. Her personal and family history was noncontributory, and she was normal on physical examination. Blood tests revealed a strongly elevated renin and slightly increased aldosterone, suggesting a renovascular cause. Nevertheless, color Doppler ultrasound, CT, and MR angiography were normal. A DMSA renal scan with and without captopril was performed with results suggestive of a right intrarenal segmental artery branch stenosis, which was corrected with arteriography. A captopril DMSA can be helpful in localizing smaller intrarenal artery branch stenoses.
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Serbis et al. (2024) studied this question.
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