What is it about?
This report describes the case of a patient who presented with severe, wildly unstable hypertension, often accompanied with the symptoms of headache, dizziness, anorexia, nausea and/or abdominal pain. His blood pressure was not amenable to control with antihypertensive drugs for more than 4 years before the cause of his hypertension as well as other complications was found to be due to defective regulation of the complement system. Institution of anticomplement therapy helped stabilize his blood pressure. It also resolved his symptoms and improved his kidney function.
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Why is it important?
Treatment of severe hypertension, malignant hypertension or hypertensive crisis is generally focused on drugs that lower the blood pressure. While this strategy works for most cases, it may be ineffective in some cases. In such difficult cases, the possibility of defective regulation of the complement system should be considered because such patients require treatment to suppress complement activation.
Perspectives
Hypertension may be a consequence of various diseases, including atypical hemolytic uremic syndrome due to defective regulation of the complement system. Most cases of atypical hemolytic uremic syndrome are recognized when it presents with the triad of renal failure, hemolysis and low platelet counts. Occasionally, atypical hemolytic uremic syndrome may present with severe hypertension unaccompanied with such a triad. In these cases, efforts to control the blood pressure with antihypertensive drugs may be ineffective or inadequate. Instead, the treatment should be directed toward suppression of complement activation.
Dr Han Mou Tsai
Han Mou Tsai
Read the Original
This page is a summary of: Does Anticomplement Therapy Have a Role in the Management of Malignant Hypertension?, Journal of Clinical Hypertension, September 2015, Wiley,
DOI: 10.1111/jch.12664.
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