Abstract

The case history is reported of a child aged 1 year 10 months with malignant hypertension in association with Wilms' tumour. In addition there was a marked electrolyte disturbance, with hyponatraemia and hypokalaemia, and a blood picture of microangiopathic haemolytic anaemia. All these features resolved after removal of the kidney and tumour. Pre-operative plasma renin concentration was extremely high and had returned to normal 3 months after operation. The renal tumour showed a marked degree of differentiation, with glomerulus-like structures attached to tubules, and significant quantities of renin were found on assay. No renin was detected in the renal cortex of the affected kidney. In two other normotensive patients with Wilms' tumour no renin could be detected in the tumour tissue. We consider that the evidence suggests that this patient had a renin-secreting nephroblastoma.