Reninoma: an unusual cause of growth failure

Nupoor Vaghasia; Ganesh Jevalikar; Mohammad Shafi Kuchay; Lipika Lipi; Ambrish Mithal

doi:10.1515/jpem-2024-0380

Article

Reninoma: an unusual cause of growth failure

Nupoor Vaghasia , Ganesh Jevalikar , Mohammad Shafi Kuchay , Lipika Lipi and Ambrish Mithal

Published/Copyright: December 12, 2024

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 38 Issue 1

Abstract

Objectives

Growth failure can result from various underlying causes, necessitating a thorough evaluation. Reninoma, a rare renin-secreting tumor, is an uncommon cause of hypertension, especially in paediatric patients, and has not been associated with growth failure until now.

Case presentation

An 11-year-old girl presented with complaints of poor height gain, headaches, increased thirst, and vomiting. The evaluation revealed severe hypertension and hypokalemic alkalosis. Investigations indicated renin-dependent hypertension, and imaging identified a right renal mass. Renal venous sampling confirmed renin production from the tumor. A right open partial nephrectomy was performed, resulting in the normalization of blood pressure and improved growth. Over the following years, she achieved a significant catch-up growth, regaining her original height percentile and the target adult height.

Conclusions

This case adds to the limited literature on paediatric reninoma. It highlights a rare presentation of reninoma causing hypertension and growth failure in a child. The growth failure was likely due to hypokalemic alkalosis-induced low insulin-like growth factor 1 (IGF-1) levels, a mechanism not previously documented in paediatric reninoma cases. Surgical excision of the tumor led to normalization of blood pressure and metabolic alkalosis with significant growth recovery.

Keywords: growth failure; growth velocity; pediatric hypertension; reninoma

Corresponding author: Nupoor Vaghasia, Department of Endocrinology and Diabetes, Max Super Speciality Hospital, Saket, Delhi 110017, India, E-mail: nupoor11@gmail.com

Research ethics: Not applicable.
Informed consent: Signed informed consent was obtained from the mother (legal guardian) of the patient for publication of this case report and any accompanying images, as the patient was a minor.
Author contributions: All authors were involved in case diagnosis, management and follow up. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Use of Large Language Models, AI and Machine Learning Tools: None declared.
Conflict of interest: The authors state no conflict of interest.
Research funding: None declared.
Data availability: Not applicable.

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Received: 2024-08-08

Accepted: 2024-11-14

Published Online: 2024-12-12

Published in Print: 2025-01-29

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Articles in the same Issue

https://doi.org/10.1515/jpem-2024-0380

Keywords for this article

growth failure; growth velocity; pediatric hypertension; reninoma