PEDIATRICS Vol. 99 No. 5 May 1997, pp. 743 (doi:10.1542/peds.99.5.743)
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Right arrow Infectious Disease & Immunity

PEDIATRICS Vol. 99 No. 5 May 1997, pp. 743-744

EXPERIENCE AND REASON:
Renovascular Hypertension and Encephalopathy in a Patient With Tuberculous Abdominal Lymphadenopathy

The first 20% of the full text of this article appears below.

    INTRODUCTION

Tuberculosis is a common disease in South Africa1 and other developing countries, and its prevalence is rising in the first world.2 Although abdominal tuberculosis is apparently less common in children than in adults,3 a significant number of children from communities with a high prevalence of tuberculosis may present with this disease. In such patients seizures and a disturbance of consciousness may be attributed to tuberculous meningitis, and other causes of these symptoms might not be considered.

We report on the case of a 7-year-old girl who presented with disseminated tuberculosis and seizures who was shown to have renovascular hypertension with encephalopathy, caused by lymph node compression of one of three right renal arteries. Renovascular hypertension due to tuberculous lymphadenopathy has not been described before.

This case illustrates an interaction between a disease common in developing countries and a common congenital anomaly4 of the renal arteries. Routine and careful measurement of blood pressure in children with disseminated tuberculosis may identify more such cases.

    CASE REPORT

A 7-year-5-month-old girl presented to a peripheral hospital with a 5-month history of weight loss, night sweats, and lethargy. A convulsion with associated loss of consciousness was the reason for eventually seeking medical help. She had four further convulsions in the hospital, which affected the left side of her body and which sometimes were associated with a loss of consciousness. Her condition deteriorated in the hospital, and her parents requested discharge to bring her to Cape Town for further medical . . . [Full Text of this Article]