Renal denervation for severe hypertension in a small child with Turner syndrome: miniaturisation of the procedure and results

BMJ Case Reports
Alice BonanniCarlo Gandolfo

Abstract

Sympathetic nervous system hyperactivity plays a role in development and progression of hypertension. While renal denervation employing radiofrequency devices has been used therapeutically in treating severe hypertension with alternate results in adults, few data are available regarding children. We treated a 6-year-old girl affected by Turner syndrome presenting severe hypertension and an episode of stroke, in spite of treatment with four antihypertensive drugs, with sympathetic ablation. The Simplicity device (Medtronic, Minneapolis, USA) was adapted to the smaller vessels, allowing a tailored approach. After 3 and 6 months of treatment, and β-blocker discontinuation, blood pressure values were set between the 90th and 95th centiles for sex and age, and normalised at 12 months. We confirm that renal denervation can be used to treat severe hypertension in children; miniaturisation of catheter and tailoring the procedure for small vessels allowed a safe approach. Progressive improvement of blood pressure had a satisfactory clinical impact.

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Citations

Jun 30, 2016·British Journal of Clinical Pharmacology·Alice BonanniGian Marco Ghiggeri
Feb 14, 2018·British Journal of Clinical Pharmacology·Alice BonanniGian Marco Ghiggeri
Oct 27, 2018·Expert Opinion on Investigational Drugs·Rossella SiligatoDomenico Santoro
May 31, 2019·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Ian Macumber, Joseph T Flynn

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