Hypertensive Crisis in a Pediatric Patient Experiencing Clonidine Withdrawal

Background. Clonidine, a central alpha-adrenoreceptor agonist, was initially developed as an antihypertensive. Though no longer commonly used for its original indication due to rebound hypertension after discontinuation, it is currently widely prescribed as a treatment for many pediatric indications...

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Main Authors: Can Cao, Matthew L. Lorenz, Phillip Sojka, Allison W. Brindle, Lisa Swartz Topor
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2022/9005063
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author Can Cao
Matthew L. Lorenz
Phillip Sojka
Allison W. Brindle
Lisa Swartz Topor
author_facet Can Cao
Matthew L. Lorenz
Phillip Sojka
Allison W. Brindle
Lisa Swartz Topor
author_sort Can Cao
collection DOAJ
description Background. Clonidine, a central alpha-adrenoreceptor agonist, was initially developed as an antihypertensive. Though no longer commonly used for its original indication due to rebound hypertension after discontinuation, it is currently widely prescribed as a treatment for many pediatric indications including sleep disorders, behavioral concerns, and attention deficit hyperactivity disorder. Case Report. We describe a girl who developed prolonged symptoms of clonidine withdrawal, including hypertension and elevated serum metanephrines. Discussion. Clonidine withdrawal in pediatric patient can present with hypertensive urgency and other signs of sympathetic stimulation. Withdrawal can also lead to dramatic elevation in serum metanephrines. Treatment with a clonidine taper will reduce development of withdrawal symptoms. Conclusion. Given the rise in clonidine use in pediatric patients, clinicians should be aware of the risk of clonidine withdrawal and how to recognize and avoid its development.
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series Case Reports in Pediatrics
spelling doaj-art-76f6c7e1f38f403b823e49b3d0d4a8532025-08-20T02:07:35ZengWileyCase Reports in Pediatrics2090-68112022-01-01202210.1155/2022/9005063Hypertensive Crisis in a Pediatric Patient Experiencing Clonidine WithdrawalCan Cao0Matthew L. Lorenz1Phillip Sojka2Allison W. Brindle3Lisa Swartz Topor4The Warren Alpert Medical School of Brown UniversityThe Warren Alpert Medical School of Brown UniversityThe Warren Alpert Medical School of Brown UniversityThe Warren Alpert Medical School of Brown UniversityThe Warren Alpert Medical School of Brown UniversityBackground. Clonidine, a central alpha-adrenoreceptor agonist, was initially developed as an antihypertensive. Though no longer commonly used for its original indication due to rebound hypertension after discontinuation, it is currently widely prescribed as a treatment for many pediatric indications including sleep disorders, behavioral concerns, and attention deficit hyperactivity disorder. Case Report. We describe a girl who developed prolonged symptoms of clonidine withdrawal, including hypertension and elevated serum metanephrines. Discussion. Clonidine withdrawal in pediatric patient can present with hypertensive urgency and other signs of sympathetic stimulation. Withdrawal can also lead to dramatic elevation in serum metanephrines. Treatment with a clonidine taper will reduce development of withdrawal symptoms. Conclusion. Given the rise in clonidine use in pediatric patients, clinicians should be aware of the risk of clonidine withdrawal and how to recognize and avoid its development.http://dx.doi.org/10.1155/2022/9005063
spellingShingle Can Cao
Matthew L. Lorenz
Phillip Sojka
Allison W. Brindle
Lisa Swartz Topor
Hypertensive Crisis in a Pediatric Patient Experiencing Clonidine Withdrawal
Case Reports in Pediatrics
title Hypertensive Crisis in a Pediatric Patient Experiencing Clonidine Withdrawal
title_full Hypertensive Crisis in a Pediatric Patient Experiencing Clonidine Withdrawal
title_fullStr Hypertensive Crisis in a Pediatric Patient Experiencing Clonidine Withdrawal
title_full_unstemmed Hypertensive Crisis in a Pediatric Patient Experiencing Clonidine Withdrawal
title_short Hypertensive Crisis in a Pediatric Patient Experiencing Clonidine Withdrawal
title_sort hypertensive crisis in a pediatric patient experiencing clonidine withdrawal
url http://dx.doi.org/10.1155/2022/9005063
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AT phillipsojka hypertensivecrisisinapediatricpatientexperiencingclonidinewithdrawal
AT allisonwbrindle hypertensivecrisisinapediatricpatientexperiencingclonidinewithdrawal
AT lisaswartztopor hypertensivecrisisinapediatricpatientexperiencingclonidinewithdrawal