Blood pressure screening is an important component of the pediatric outpatient visit. The following case describes a 9-year-old male with a medical history significant for prematurity, obesity, asthma, and secondary nighttime enuresis who was admitted to our institution with hypertensive urgency. His blood pressure on presentation was 166/122 mm Hg, and he was clinically asymptomatic. There is a strong family history of hypertension, renal disease, and brain cancer. During his admission, his blood pressures were medically managed. He received a comprehensive diagnostic investigation of possible primary or secondary causes of hypertension, including consultation with nephrology, endocrinology, and ophthalmology subspecialty teams. The etiology of the hypertension was determined, and he was subsequently treated for a rare and life-threatening disease. This case highlights the importance of the close surveillance of children with hypertension.
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