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An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the Literature

INTRODUCTION: A paraganglioma (PGL) is a tumour derived from extra-adrenal chromaffin cells of the sympathetic paravertebral ganglia of the thorax, abdomen, and pelvis. Cardiovascular manifestations predominate but neurological symptoms like seizures can occur requiring a high index of suspicion for...

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Autores principales: Oyenusi, Elizabeth Eberechi, Nwigbo, Uzoamaka Felicia, Oladipo, Oluwadamilola Moromoke, Kene-Udemezue, Blessing Ebele, Akowundu, Kasarachi Pauline, Oleolo-Ayodeji, Khadijah Omobusola, Afoke, Oluwaseun Adunni, Babatunde, Funmilayo Oluwatoyin, Alakaloko, Felix Makinde, Asiyanbi, Gabriel Kolawole, Ogunleye, Ezekiel Olayiwola, Oduwole, Abiola Olufunmilayo, Lesi, Foluso Ebun Afolabi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696474/
http://dx.doi.org/10.1155/2023/6637802
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author Oyenusi, Elizabeth Eberechi
Nwigbo, Uzoamaka Felicia
Oladipo, Oluwadamilola Moromoke
Kene-Udemezue, Blessing Ebele
Akowundu, Kasarachi Pauline
Oleolo-Ayodeji, Khadijah Omobusola
Afoke, Oluwaseun Adunni
Babatunde, Funmilayo Oluwatoyin
Alakaloko, Felix Makinde
Asiyanbi, Gabriel Kolawole
Ogunleye, Ezekiel Olayiwola
Oduwole, Abiola Olufunmilayo
Lesi, Foluso Ebun Afolabi
author_facet Oyenusi, Elizabeth Eberechi
Nwigbo, Uzoamaka Felicia
Oladipo, Oluwadamilola Moromoke
Kene-Udemezue, Blessing Ebele
Akowundu, Kasarachi Pauline
Oleolo-Ayodeji, Khadijah Omobusola
Afoke, Oluwaseun Adunni
Babatunde, Funmilayo Oluwatoyin
Alakaloko, Felix Makinde
Asiyanbi, Gabriel Kolawole
Ogunleye, Ezekiel Olayiwola
Oduwole, Abiola Olufunmilayo
Lesi, Foluso Ebun Afolabi
author_sort Oyenusi, Elizabeth Eberechi
collection PubMed
description INTRODUCTION: A paraganglioma (PGL) is a tumour derived from extra-adrenal chromaffin cells of the sympathetic paravertebral ganglia of the thorax, abdomen, and pelvis. Cardiovascular manifestations predominate but neurological symptoms like seizures can occur requiring a high index of suspicion for prompt diagnosis and treatment. Case Description. A 14-year-old girl was referred to the paediatric neurology unit for recurrent headaches of one-year duration, vomiting of 2 months duration, and an episode of generalized tonic-clonic seizures, 2 weeks prior to presentation. There was an associated history of impaired vision, palpitations, diaphoresis, and easy fatigability. Her blood pressure ranged from 150/101 to 160/120 mmHg. The brain CT scan was normal. ECG showed left ventricular hypertrophy. Abdominal USS revealed a right para-aortic mass necessitating 24-hour urine normetanephrine which was markedly elevated–1695.34 mcg/24 h (100–500). An abdominal CT scan confirmed a paraganglioma in the right para-aortic region. A multidisciplinary team consisting of paediatric endocrinologists, radiologists, anaesthetists, paediatric and cardiothoracic surgeons, and the intensive care unit (ICU) team was involved in the peri and postoperative management of the child. Intraoperative challenges were hypertension and hypotension (following tumour excision). She was nursed in the ICU for 48 hours. Histology results confirmed paraganglioma. Postoperative urine normetanephrines done a month after surgery had reverted to normal. Her blood pressure has remained normal 6 months after surgery, and no other symptoms have recurred. CONCLUSION: In evaluating aetiology of childhood hypertension, endocrine causes must be considered though they are rare. The occurrence of paraganglioma is uncommon and can present in unusual ways such as seizures. Measurement of blood pressure in children is advocated as part of routine health care. Clinicians must explore the aetiology of seizures and not merely control them with anticonvulsant therapy.
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spelling pubmed-106964742023-12-06 An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the Literature Oyenusi, Elizabeth Eberechi Nwigbo, Uzoamaka Felicia Oladipo, Oluwadamilola Moromoke Kene-Udemezue, Blessing Ebele Akowundu, Kasarachi Pauline Oleolo-Ayodeji, Khadijah Omobusola Afoke, Oluwaseun Adunni Babatunde, Funmilayo Oluwatoyin Alakaloko, Felix Makinde Asiyanbi, Gabriel Kolawole Ogunleye, Ezekiel Olayiwola Oduwole, Abiola Olufunmilayo Lesi, Foluso Ebun Afolabi Case Rep Endocrinol Case Report INTRODUCTION: A paraganglioma (PGL) is a tumour derived from extra-adrenal chromaffin cells of the sympathetic paravertebral ganglia of the thorax, abdomen, and pelvis. Cardiovascular manifestations predominate but neurological symptoms like seizures can occur requiring a high index of suspicion for prompt diagnosis and treatment. Case Description. A 14-year-old girl was referred to the paediatric neurology unit for recurrent headaches of one-year duration, vomiting of 2 months duration, and an episode of generalized tonic-clonic seizures, 2 weeks prior to presentation. There was an associated history of impaired vision, palpitations, diaphoresis, and easy fatigability. Her blood pressure ranged from 150/101 to 160/120 mmHg. The brain CT scan was normal. ECG showed left ventricular hypertrophy. Abdominal USS revealed a right para-aortic mass necessitating 24-hour urine normetanephrine which was markedly elevated–1695.34 mcg/24 h (100–500). An abdominal CT scan confirmed a paraganglioma in the right para-aortic region. A multidisciplinary team consisting of paediatric endocrinologists, radiologists, anaesthetists, paediatric and cardiothoracic surgeons, and the intensive care unit (ICU) team was involved in the peri and postoperative management of the child. Intraoperative challenges were hypertension and hypotension (following tumour excision). She was nursed in the ICU for 48 hours. Histology results confirmed paraganglioma. Postoperative urine normetanephrines done a month after surgery had reverted to normal. Her blood pressure has remained normal 6 months after surgery, and no other symptoms have recurred. CONCLUSION: In evaluating aetiology of childhood hypertension, endocrine causes must be considered though they are rare. The occurrence of paraganglioma is uncommon and can present in unusual ways such as seizures. Measurement of blood pressure in children is advocated as part of routine health care. Clinicians must explore the aetiology of seizures and not merely control them with anticonvulsant therapy. Hindawi 2023-11-27 /pmc/articles/PMC10696474/ http://dx.doi.org/10.1155/2023/6637802 Text en Copyright © 2023 Elizabeth Eberechi Oyenusi et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Oyenusi, Elizabeth Eberechi
Nwigbo, Uzoamaka Felicia
Oladipo, Oluwadamilola Moromoke
Kene-Udemezue, Blessing Ebele
Akowundu, Kasarachi Pauline
Oleolo-Ayodeji, Khadijah Omobusola
Afoke, Oluwaseun Adunni
Babatunde, Funmilayo Oluwatoyin
Alakaloko, Felix Makinde
Asiyanbi, Gabriel Kolawole
Ogunleye, Ezekiel Olayiwola
Oduwole, Abiola Olufunmilayo
Lesi, Foluso Ebun Afolabi
An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the Literature
title An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the Literature
title_full An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the Literature
title_fullStr An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the Literature
title_full_unstemmed An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the Literature
title_short An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the Literature
title_sort atypical presentation of childhood paraganglioma with seizures: a case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696474/
http://dx.doi.org/10.1155/2023/6637802
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