Malignant hypertension in a child with hemolytic-uremic syndrome treated with captopril

Captopril in severe childhood hypertension--reversible anaemia with high dosage

Experience with chronic inhibition of the angiotensin-converting enzyme in children is limited to cases refractory to all other forms of treatment. In reports dealing with the use of captopril (Capoten-R) in children no important side-effects are mentioned. This report describes a 7-year-old boy with severe hypertension secondary to haemolytic uraemic syndrome. Good pressure control was obtained after introduction of captopril. However, under the high initial dosage, pronounced anaemia developed within the first 3 months of treatment. The anaemia responded to dose-reduction while pressure control was maintained. Serial echocardiographic studies were performed. They illustrate the beneficial haemodynamic effects of captopril in the follow-up of children under antihypertensive treatment. Some recommendations are made on the use of captopril in children.