A case of atypical reninoma with mild hypertension and normal plasma renin activity but elevated plasma renin concentration

BMC Endocrine Disorders

Bo Bian¹  Jiabo Wang²  Qing He³  Li Ding³  Baoping Wang³  Ming Liu³  Yuxin Fan³  Shuanghua Xu³  Xin Zhao⁴  Diansheng Fu⁴  Zuoliang Dong⁵  Chunsheng Ni⁶  Kunlong Tang⁷ 

[1] Department of Cardiology, Tianjin Medical University General Hospital;Department of Clinical Medicine, Tianjin Medical University;Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital;Department of Imaging, Tianjin Medical University General Hospital;Department of Medical Laboratory, Tianjin Medical University General Hospital;Department of Pathology, Tianjin Medical University General Hospital;Department of Urology, Tianjin Medical University General Hospital;

关键词: Reninoma;    Atypical reninoma;    Plasma renin concentration;    Plasma renin activity;    Case report;   

DOI  :  10.1186/s12902-022-00977-w

来源: DOAJ

【 摘 要 】

Abstract Background Reninoma is a rare, benign renal neoplasm. Typical clinical features include severe hypertension, secondary hyperaldosteronism, hypokalaemia and metabolic alkalosis caused by the overproduction of renin. Case presentation A 25-year-old lean Chinese woman with no family history of hypertension was hospitalized for stage 1 hypertension that gradually developed over two years. Endocrine investigation showed hyperreninemia without hyperaldosteronism and hypokalaemia. Interestingly, although the patient had an elevated plasma renin concentration (PRC), her plasma renin activity (PRA) was in the normal range. Abdominal contrast-enhanced computed tomography (CT) scanning revealed a solid, low-density, renal cortical mass with delayed enhancement. Selective renal vein sampling (SRVS) was performed, and a lateralization of the renin secretion from the left kidney was found. Enucleation of the tumour led to a rapid remission of hypertension and hyperreninemia. Based on pathological findings, the patient was diagnosed with reninoma. Immunohistochemical staining of the tumour was positive for Renin, CD34, Vimentin, and synaptophysin (Syn) and negative for somatostatin receptor 2 (SSTR2) and chromogranin A (CgA). Conclusions Reninoma can present as mild hypertension without hyperaldosteronism and hypokalaemia. The clinical features of reninoma may depend on the degree of activation of the renin-angiotensin-aldosterone system (RAAS). PRC should be incorporated in the differential diagnosis of secondary hypertension.

【 授权许可】

Unknown