What can cause extreme hypertinsion in a 5 year old?

  My daughter is 5 years old and we have just descovered that she has very high BPs...113/100 is an average. Some blood work has been done and there were elevated factors, but I do not know what they were.  Our Neuro is from out of town and we only see him every 3 months,we do talk via the phone and fax though.  Regardless, communication is still not the greatest.
  I am very worried that she will have another stroke.  Thank you  Barbara
Dear Barbara:
I am sorry to hear about your daughter.  A few questions, what were the abnormal blood tests?  Does she have hypercoag. prolife abnormalities?  Was her sedimentation rate elevated?  Did your physician say that she had a vasculitis picture?  Did you daughter recently have the chicken pox?  When was her last stroke?  What was the etiology of the last stroke?  Is there a history of a hypercoag. events in your family, i.e. DVT, early stroke or MI?  By your note, I as assuming that your daughter has had a previous stroke, and now has elevated blood pressure.  Your daughter may need angiography to investigate the possibility of fibromuscular dysplasia, vasculitis, or AVM.  Did your daughter have an MRI/MRA to look at her cerebral vasculature?  Hypertension in a 5 year old is very unusual.  Given, the CNS involvement of previous stroke with elevated factors (?), this should be intensively investigated.  There are renal problems as well as CNS problems that may be involved, either isolated or together.  I strongly
suggest that you talk this over with your pediatrician and pediatric neurologist to began the diagnostic workup for the etiology of the hypertension and stroke.  I am sorry that I can't give you a more definitive answer.  Without knowledge of the abnormal lab work and access to the neuroimaging studies it is impossible to give you a diagnosis.  As previously mentioned, with the history in your note, vasculitis, hypercoag state, fibromuscluar dysplasia, or moya-moya are possibilities.
Sincerely,
CCF Neuro:Pediatrics, MD RPS