Hypertension of renal origin in a child presenting with peripheral facial paralysis: Case report

Abstract

We present 6.5 years-old girl with left peripheral facial paralysis which developed by hypertension secondary to renal etiology. After getting 1 mg/kg/day prednisolone for peripheral facial paralysis in another center, she was hospitalized for high fever and stage 2 hypertension [blood pressure 190/140 mmHg (>99p+5 mmHg/>99p+5 mmHg)]. Oral nifedipine followed by enalapril and amlodipine successfully normalized blood pressure. Intravenous ceftriaxone was given for acute pyelonephritis. Fundoscopy revealed stage 1-2 hypertensive retinopathy. Echocardiography demonstrated left ventricular hypertrophy. Ultrasonography showed right renal focal pyelonephritic zone and atrophic left kidney. She had left grade 3 and right grade 2 vesico-ureteral reflux on voiding cystourethrography and stage 2 chronic renal disease. Dimercaptosuccinic acid scintigraphy showed right renal scarring in upper-middle poles and left renal atrophy. After subureteric dextranomer/ hyaluronic acid injection, vesico-ureteral reflux was corrected. As peripheral facial paralysis was complication of hypertension secondary to reflux nephropathy, importance of blood pressure measurement and urinary tract infection diagnosis in children should be remembered.