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Hypertension in Pheochromocytoma and Paraganglioma: Evaluation and Management in Pediatric Patients

Authors
  • Seamon, Meredith L.1
  • Yamaguchi, Ikuyo2
  • 1 University of Utah, 81 N. Mario Capecchi Drive, Salt Lake City, UT, 84113, USA , Salt Lake City (United States)
  • 2 The University of Oklahoma College of Medicine, Oklahoma City, OK, USA , Oklahoma City (United States)
Type
Published Article
Journal
Current Hypertension Reports
Publisher
Springer-Verlag
Publication Date
May 27, 2021
Volume
23
Issue
5
Identifiers
DOI: 10.1007/s11906-021-01150-9
Source
Springer Nature
Keywords
License
Yellow

Abstract

Purpose of ReviewThe rare catecholamine-secreting tumors, pheochromocytomas and paragangliomas (PPGL), account for a minority of cases of secondary hypertension in pediatrics. As such, perioperative blood pressure (BP) management in pediatric patients presents a distinct challenge. This review will expand the practitioner’s knowledge of antihypertensive treatment options for the pediatric patient with PPGL with a focus on literature in the past several years.Recent FindingsThere continue to be only small case series and single-center experiences to provide guidelines regarding BP management. While phenoxybenzamine has been more routinely used, selective α1-blockers, such as doxazosin, as well as calcium channel blockers, have also been utilized with success in pediatric patients.SummaryWhile the concept of obligatory α-adrenergic blockade for adult patients has been recently challenged, international guidelines and current practice patterns among pediatric clinicians continue to support preoperative α-adrenergic blockade to ensure the best possible patient outcomes. Selective α1-blockers and calcium channel blockers are becoming more commonly used given the high cost, limited availability, and undesirable side effect profile of phenoxybenzamine.

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