Secondary hypertension: beyond the diagnosis
DOI:
https://doi.org/10.32385/rpmgf.v41i1.13914Keywords:
Adrenocortical carcinoma, Hypertension, Secondary hypertension, General and family medicineAbstract
Introduction: Hypertension is a multifaceted condition, often attributed to several secondary causes. Understanding these causes is crucial due to the potential lethality of some conditions, although rare, that affect both the individual and their family.
Case description: A 26-year-old female patient, without any significant past medical history, presented at her Family Health Unit (FHU) with a headache and high blood pressure. Following the study of secondary causes, a mass was detected in the adrenal gland, which turned out to be an adrenocortical carcinoma producing cortisol and androgens, locally advanced, and with liver metastasis. The patient was proposed for palliative chemotherapy, which she did not complete. She was monitored at the Porto Hospital Center and simultaneously with the family doctor until her death.
Comment: This clinical case aims to illustrate a rare cause of secondary hypertension diagnosed in primary health care and emphasizes the importance of the family doctor in its correct identification and guidance.
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References
1. Dinis PG, Cachulo MC, Fernandes A, Paiva L, Gonçalves L. Hipertensão arterial sistémica secundária: incertezas do diagnóstico [Secondary arterial hypertension: uncertainties in diagnosis]. Acta Med Port. 2017;30(6):493-6. Portuguese
2. Costa T, Leitão DC. Hipertensão secundária: abordagem nos cuidados de saúde primários [Secondary hypertension: primary health care approach]. Rev Port Med Geral Fam. 2021;37(6):535-48. Portuguese
3. Rimoldi SF, Scherrer U, Messerli FH. Secondary arterial hypertension: when, who, and how to screen? Eur Heart J. 2014;35(19):1245-54.
4. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens. 2018;36(10):1953-2041.
5. Bustos-Merlo A, Rosales-Castillo A, Jaén-Águila F. Forma monogénica de hipertensión arterial secundaria [Monogenic form of secondary arterial hypertension]. Hipertens Riesgo Vasc. 2022;39(3):135-7. Spanish
6. Broco S, Bonito N, Sousa G, Gervásio H. O carcinoma do córtex suprarrenal: um desafio diagnóstico e terapêutico [Adrenocortical carcinoma: a diagnostic and therapeutic challenge]. Med Interna. 2010;17(1):65-7. Portuguese
7. Alecu L, Costan I, Viţalariu A, Lungu C, Obrocea F, Gulinescu L. Carcinom de glandă corticosuprarenală [Cortico-suprarenal carcinoma]. Chirurgia (Bucur). 2002;97(6):587-91. Romanian
8. Abeynayake DR, Sopan V, Perera KJ, Paramanantham A, Munasinghe TM. Adrenal carcinoma: a case report. J Med Case Rep. 2022;16(1):229.
9. Allen J, Gay B, Crebolder H, Heyrman J, Svab I, Ram P, et al. A definição Europeia de medicina geral e familiar (clínica geral/medicina familiar) [The European definition of family medicine (general practice/family medicine). Rev Port Clin Geral. 2005;21(5):511-6. Portuguese
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