Pediatric Hypertension: A Case Report of an Unusual Presentation

Pediatric hypertension is often asymptomatic but can signal underlying secondary causes such as renal or renovascular diseases. Ureteropelvic junction obstruction (UPJO) is a leading cause of upper urinary tract dilation in children. Although it typically presents with abdominal pain, hematuria, or urinary tract infections, it may, in rare cases, manifest solely as hypertension. This case report describes an eight-year-old boy with asymptomatic hypertension and proteinuria detected during routine screening. Imaging revealed a left-sided UPJO with renal impairment, as well as horseshoe kidneys with fusion at the lower poles. The patient was treated with antihypertensives and underwent successful surgical correction, with ongoing nephrology follow-up. This case underscores the importance of routine blood pressure monitoring in children to enable early diagnosis of silent renal pathologies, facilitating timely treatment and improved outcomes.