Renovascular Hypertension and Encephalopathy in a Patient With Tuberculous Abdominal Lymphadenopathy

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.