Reninom kao uzrok teške hipertenzije i lošeg ishoda trudnoće mlade žene

  • Danica Stamenković-Pejković Clinical Center of Serbia, *Clinic for Endocrinology, Belgrade, Serbia
  • Mirjana Šumarac-Dumanović Clinical Center of Serbia, Clinic for Endocrinology; University of Belgrade, Faculty of Medicine, Serbia
  • Nebojša Bojanić Clinical Center of Serbia, Clinic for Urology, University of Belgrade, Faculty of Medicine, Serbia
  • Jasmina Marković-Lipkovski Clinical Center of Serbia, Institute for Pathology, University of Belgrade, Faculty of Medicine, Serbia
  • Jelena Vještica Clinical Center of Serbia, Institute for Pathology, University of Belgrade, Faculty of Medicine, Serbia
  • Aleksandar Ivanović Clinical Center of Serbia, Center for Radiology and Magnetic Resonance, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Serbia
  • Goran Cvijović Clinical Center of Serbia, Clinic for Endocrinology; University of Belgrade, Faculty of Medicine, Serbia
  • Ana Gligić Clinical Center of Serbia, Clinic for Endocrinology, Belgrade, Serbia
  • Uroš Bumbaširević Clinical Center of Serbia, Clinic for Urology, Belgrade, Serbia
  • Svetlana Jelić University of Belgrade, Faculty of Medicine, Serbia; Clinical Hospital Center “Bežanijska kosa”, Belgrade, Serbia
  • Snežana Polovina Clinical Center of Serbia, Clinic for Endocrinology, Belgrade, Serbia
  • Dragan Micić Clinical Center of Serbia, Clinic for Endocrinology; University of Belgrade, Faculty of Medicine, Serbia
DOI: https://doi.org/10.2298/VSP151215269S
Ključne reči: juxtaglomerular apparatus||, ||jukstaglomerularni aparat, kidney neoplasms||, ||bubreg, neoplazme, hypertension||, ||hipertenzija, fetal death||, ||fetus, smrt, diagnostic techniques and procedures||, ||dijagnostičke tehnike i procedure, diagnosis, differential||, ||dijagnoza, diferencijalna, urologic surgical proceduresurologic surgical procedures||, ||hirurgija, urološka, procedure,

Sažetak


Uvod. Jukstaglomerularni ćelijski tumor (JGĆT) ili reninom је veoma redak uzrok hipertenzije kod mladih ljudi. Najvažnija je rana dijagnoza koja se postavlja na osnovu kliničke prezentacije, hormonskih i radioloških nalaza, pre svega kompjuterizovane tomografije (KT) i magnetne rezonance (MR). Finalna potvrda dijagnoze JGĆT je prisustvo lateralizacije plazma reninske aktivnosti (PRA) tokom selektivnog uzorkovanja krvi iz renalne vene. Prikaz slučaja. Prikazan je tipičan slučaj mlade žene sa JGĆT koji se prvi put manifestovao ozbiljnom hipertenzijom tokom trudnoće i bio uzrok smrti ploda. Nakon pobačaja dijagnoza JGĆT postavljena je na osnovu CT pregleda i potvrđena je selektivnim uzorkovanjem krvi iz renalne vene. Nakon parcijalne nefrektomije došlo je do normalizacije vrednosti krvnog pritiska i vrednosti kalijuma u serumu. Zaključak. Na JGĆT treba misliti u diferencijalnoj dijagnozi ozbiljne hipertenzije tokom trudnoće kao i kod mladih ljudi (naročito žena) sa hipokalijemijom i sekundarnim hiperaldosteronizmom nakon isključenja drugih uzroka kao što je renalna arterijska stenoza. Dinamski kontrastni KT, MR i selektivno uzorkovanje krvi iz renalne vene najvažnije su procedure u postavljanju dijagnoze JGĆT.

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Objavljeno
2017/10/27
Broj časopisa
Vol. 74 Br. 10 (2017)
Rubrika
Prikaz bolesnika