17-year-old boy's blood pressure soared to 200

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The 17-year-old Xiao He is young and has no bad habits, but his blood pressure often soars to 180 or even 200 for no reason. When I went to the Pearl River Hospital of Southern Medical University for an examination, I found out that it was the adrenal glands at work. After Xu Yawen, deputy director of the urology department of the hospital, removed the "culprit" pheochromocytoma for him, Xiao He's blood pressure also returned to normal.
Xu Yawen said that in the concept of most people, if the blood pressure is high, it is necessary to find a cardiologist to take antihypertensive drugs, but in fact, combined with his clinical experience and literature data, more than 15% of hypertension and urology-related diseases Concerning, especially adrenal disease, most of these patients sooner or later require a urologist to treat the adrenal glands.
A variety of adrenal diseases can induce hypertension
The adrenal gland is a very important endocrine organ in the human body. It is located in the front and upper part of the inner side of the kidney. It is about 5cm long, 2.5cm wide, 0.5cm thick, and weighs about 5 grams. The main function of the adrenal glands is to secrete various hormones. Under normal circumstances, the amount of each hormone is relatively stable to balance the functions of the human body. Once the adrenal gland changes and secretes too much certain hormones, it will cause various symptoms such as high blood pressure, osteoporosis, muscle weakness, increased nocturia, irritability, and difficulty in controlling emotions.
Xu Yawen reminded that some hypertension caused by adrenal disease has no symptoms in the early stage, and it is easy to be misdiagnosed as primary hypertension and undergo simple drug treatment. But in fact, unlike the common primary hypertension in the elderly, many secondary hypertension caused by adrenal-related diseases can be cured. But must intervene early, otherwise, its consequences and complications may be more serious than essential hypertension.
For example, adrenal aldosteronoma can cause muscle weakness, affect swallowing and even affect breathing; adrenal cortisol can cause rapid obesity, fat accumulation, pathological fractures, and neuropsychiatric symptoms in patients; adrenal pheochromocytoma will eventually cause patients to develop Severe cardiomyopathy.
Watch out for adrenal disease when these symptoms appear
How to do early detection? Xu Yawen introduced that hypertensive patients, especially young hypertensive patients, exclude genetic factors, and at the same time as blood pressure rises, if they are accompanied by uncontrollable obesity, intermittent or persistent muscle weakness, easy agitation or difficulty in controlling emotions and other symptoms, they need to be Consider hypertension associated with adrenal disease.
Some high blood pressure caused by adrenal disease will have many symptoms that essential hypertension does not appear. For example, people with essential hypertension may experience dizziness, but those with high blood pressure due to adrenal disease may experience headaches. Some patients will experience edema, gain weight inexplicably, and even change their appearance. "Some women suddenly have small beards on their lips, thick eyebrows and prominent cheekbones, showing the characteristics of a 'full moon face', so they must be vigilant." Deputy Director Xu Yawen said.
Of course, to confirm the diagnosis, mainly rely on blood, urine test and CT, magnetic resonance and other tests. Usually, the adrenal glands that secrete too much hormone will change in shape, mainly because they grow "adenoma" or "hyperplasia" and become thick. Due to the deep location and small size of the adrenal gland, it is usually difficult to detect its morphological changes, especially early changes, by B-ultrasound.
Hypertension caused by adrenal disease, early surgery can be "rooted"
In terms of treatment, high blood pressure caused by adrenal disease can be cured by surgery in the early stage; in some patients, long-term high blood pressure can cause vascular degeneration, although surgery cannot restore blood pressure in these patients. Normal, it can also slow the progression of their high blood pressure, reduce the type and number of antihypertensive drugs they take.
Xu Yawen said that currently it is mainly done through minimally invasive laparoscopic techniques, which will cause less damage to patients and faster recovery. It is understood that the largest adrenal tumor completed by Xu Yawen's team through laparoscopy has a diameter of 20 cm, which is at the leading domestic level.
Among them, there is a relatively rare adrenal pheochromocytoma of particular concern. Xu Yawen introduced that the incidence of this disease is 1-3 per 100,000 people. The incidence is not high, but it is easy to cause very serious hypertension. The 17-year-old boy with a blood pressure of 180-200 mentioned at the beginning of the article was diagnosed with adrenal pheochromocytoma. About 10% of adrenal pheochromocytomas have familial aggregation, which is more difficult to handle. Deputy Director Xu Yawen has performed laparoscopic unilateral or bilateral pheochromocytoma surgery for three siblings of a family in Guangdong in recent years.
"The risk of adrenal pheochromocytoma resection is relatively high, and intraoperative blood pressure is likely to fluctuate greatly." Xu Yawen said, not only that, about 10% of pheochromocytomas are not on the adrenal gland. It is treated as a common tumor for surgery, and the patient will be life-threatening in severe cases. Therefore, it is recommended that patients try to choose a urology specialist with more mature technology and richer experience.