Clinical characteristics and outcomes of children with hypertensive encephalopathy
Abstract Background Hypertensive encephalopathy (HE) is characterized by a severe increase in blood pressure, leading to neurological symptoms such as severe headache, seizure, and mental status change. Prompt medical treatment is crucial, often leading to full recovery without long-term neurologica...
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2025-07-01
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| Series: | BMC Pediatrics |
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| Online Access: | https://doi.org/10.1186/s12887-025-05909-w |
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| author | Boonsita Wiraboonchai Chaiyos Khongkhatithum Norrarath Nimkarn Songkiat Chantarogh Pawaree Saisawat Kanchana Tangnararatchakit Kwanchai Pirojsakul |
| author_facet | Boonsita Wiraboonchai Chaiyos Khongkhatithum Norrarath Nimkarn Songkiat Chantarogh Pawaree Saisawat Kanchana Tangnararatchakit Kwanchai Pirojsakul |
| author_sort | Boonsita Wiraboonchai |
| collection | DOAJ |
| description | Abstract Background Hypertensive encephalopathy (HE) is characterized by a severe increase in blood pressure, leading to neurological symptoms such as severe headache, seizure, and mental status change. Prompt medical treatment is crucial, often leading to full recovery without long-term neurological deficits. However, untreated cases can result in serious complications. This study aimed to describe the clinical characteristics and outcomes of children who developed HE. Materials and methods A retrospective review of medical records in patients aged < 18 years diagnosed with HE in Ramathibodi Hospital was conducted. Data were collected, including demographics, underlying conditions, clinical presentations, blood pressure levels during HE, medications used, diagnostic investigations, and outcomes. Patients with pre-existing neurological symptoms or incomplete data were excluded. Data between the groups with kidney diseases and non-kidney diseases were compared. Results Fifty-three patients (26 males) were included with a mean age of 8.9 ± 4 years and a median follow-up time of 47.8 months. Kidney disease (51%) was the most common cause of hypertension. Patients with kidney disease were older (10.3 vs. 7.5 years, p = 0.01), had a shorter duration between the diagnosis of underlying conditions and development of HE (70 vs. 457 days, p = 0.04), and a larger proportion of females (66.7% vs. 34.6%, p = 0.02). Neither clinical manifestations, such as generalized tonic-clonic seizures, headaches, and mental status changes, nor survival were different between the kidney and non-kidney groups. Five patients who developed recurrent episodes of HE had the underlying diseases involving endothelial injuries, such as small vessel vasculitis, and were on calcineurin inhibitors after hematopoietic stem cell transplantation (HSCT). Conclusions Patients with kidney diseases were older and developed HE earlier, but there was no difference in survival between the kidney and non-kidney groups. Recurrent episodes of HE were detected in patients with small vessel vasculitis or taking calcineurin inhibitors after HSCT, prompting the pediatricians to be vigilant for blood pressure control in these patients. |
| format | Article |
| id | doaj-art-7e5e3c96eaf1432cb0948a41f3db631f |
| institution | Kabale University |
| issn | 1471-2431 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj-art-7e5e3c96eaf1432cb0948a41f3db631f2025-08-20T03:42:10ZengBMCBMC Pediatrics1471-24312025-07-012511710.1186/s12887-025-05909-wClinical characteristics and outcomes of children with hypertensive encephalopathyBoonsita Wiraboonchai0Chaiyos Khongkhatithum1Norrarath Nimkarn2Songkiat Chantarogh3Pawaree Saisawat4Kanchana Tangnararatchakit5Kwanchai Pirojsakul6Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDepartment of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDepartment of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDepartment of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDepartment of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDepartment of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDepartment of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityAbstract Background Hypertensive encephalopathy (HE) is characterized by a severe increase in blood pressure, leading to neurological symptoms such as severe headache, seizure, and mental status change. Prompt medical treatment is crucial, often leading to full recovery without long-term neurological deficits. However, untreated cases can result in serious complications. This study aimed to describe the clinical characteristics and outcomes of children who developed HE. Materials and methods A retrospective review of medical records in patients aged < 18 years diagnosed with HE in Ramathibodi Hospital was conducted. Data were collected, including demographics, underlying conditions, clinical presentations, blood pressure levels during HE, medications used, diagnostic investigations, and outcomes. Patients with pre-existing neurological symptoms or incomplete data were excluded. Data between the groups with kidney diseases and non-kidney diseases were compared. Results Fifty-three patients (26 males) were included with a mean age of 8.9 ± 4 years and a median follow-up time of 47.8 months. Kidney disease (51%) was the most common cause of hypertension. Patients with kidney disease were older (10.3 vs. 7.5 years, p = 0.01), had a shorter duration between the diagnosis of underlying conditions and development of HE (70 vs. 457 days, p = 0.04), and a larger proportion of females (66.7% vs. 34.6%, p = 0.02). Neither clinical manifestations, such as generalized tonic-clonic seizures, headaches, and mental status changes, nor survival were different between the kidney and non-kidney groups. Five patients who developed recurrent episodes of HE had the underlying diseases involving endothelial injuries, such as small vessel vasculitis, and were on calcineurin inhibitors after hematopoietic stem cell transplantation (HSCT). Conclusions Patients with kidney diseases were older and developed HE earlier, but there was no difference in survival between the kidney and non-kidney groups. Recurrent episodes of HE were detected in patients with small vessel vasculitis or taking calcineurin inhibitors after HSCT, prompting the pediatricians to be vigilant for blood pressure control in these patients.https://doi.org/10.1186/s12887-025-05909-wHypertensive encephalopathyOutcomesChildrenCharacteristics |
| spellingShingle | Boonsita Wiraboonchai Chaiyos Khongkhatithum Norrarath Nimkarn Songkiat Chantarogh Pawaree Saisawat Kanchana Tangnararatchakit Kwanchai Pirojsakul Clinical characteristics and outcomes of children with hypertensive encephalopathy BMC Pediatrics Hypertensive encephalopathy Outcomes Children Characteristics |
| title | Clinical characteristics and outcomes of children with hypertensive encephalopathy |
| title_full | Clinical characteristics and outcomes of children with hypertensive encephalopathy |
| title_fullStr | Clinical characteristics and outcomes of children with hypertensive encephalopathy |
| title_full_unstemmed | Clinical characteristics and outcomes of children with hypertensive encephalopathy |
| title_short | Clinical characteristics and outcomes of children with hypertensive encephalopathy |
| title_sort | clinical characteristics and outcomes of children with hypertensive encephalopathy |
| topic | Hypertensive encephalopathy Outcomes Children Characteristics |
| url | https://doi.org/10.1186/s12887-025-05909-w |
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