Hypertension secondary to bilateral hydronephrosis caused by a large uterine myoma.

摘要

Individuals with secondary hypertension constitute 5%-10% of the hypertensive population, with most cases of secondary hypertension attributable to kidney disease.1 Only rarely has secondary hypertension been linked to hydronephrosis.We report the case of 26-year-old woman with secondary hypertension due to bilateral hydronephrosis caused by uterine myoma. This patient first noticed an abdominal mass ~3 months before presentation. At the initial evaluation, she presented with abdominal distension, nausea, and blood pressure of 220/120 mm Hg. Laboratory results included urea nitrogen level of 12 mg/dL (4.28 mmol/L) and serum creatinine level of 1.21 mg/dL (107 jiunol/L). Thyroid function test results and 24-hour urine catecholamine levels were within normal limits. Urine dipstick was negative for blood or protein, and sediment was bland. Computed tomography of the abdomen showed a heterogeneous enhancing mass (26 X 25 X 30 cm) with bilateral hydronephrosis attributed to compression (Fig 1). Exploratory laparotomy and myomec-tomy were performed. At 1 and 6 months after laparotomy, blood pressure was normal in the absence of antihyperten-sive medications, and hydronephrosis was absent on renal ultrasonography.