Current Hypertension Reports | 2021
Hypertension in Pheochromocytoma and Paraganglioma: Evaluation and Management in Pediatric Patients
Abstract
Purpose of Review The rare catecholamine-secreting tumors, pheochromocytomas and paragangliomas (PPGL), account for a minority of cases of secondary hypertension in pediatrics. As such, perioperative blood pressure (BP) management in pediatric patients presents a distinct challenge. This review will expand the practitioner’s knowledge of antihypertensive treatment options for the pediatric patient with PPGL with a focus on literature in the past several years. Recent Findings There continue to be only small case series and single-center experiences to provide guidelines regarding BP management. While phenoxybenzamine has been more routinely used, selective α 1 -blockers, such as doxazosin, as well as calcium channel blockers, have also been utilized with success in pediatric patients. Summary While the concept of obligatory α-adrenergic blockade for adult patients has been recently challenged, international guidelines and current practice patterns among pediatric clinicians continue to support preoperative α-adrenergic blockade to ensure the best possible patient outcomes. Selective α 1 -blockers and calcium channel blockers are becoming more commonly used given the high cost, limited availability, and undesirable side effect profile of phenoxybenzamine.