ABSTRACT
Background: Hyponatremic-hypertensive syndrome (HHS) is characterized bycombination of polyuria, polydipsia, hypertension, hyponatremia and hypokalemia inassociation with unilateral renal artery stenosis. Case characteristics: A 10-year- old girlpresented with polyuria, polydipsia, hypertension, hyponatremia, hypokalemia andproteinuria. Ultrasonography with doppler study revealed bilateral normal renal arteries.Completed tomography of abdomen detected a left adnexal mass, which was laterconfirmed as ovarian paraganglioma on histopathology. Outcome: After tumor excision,polyuria subsided and blood pressure normalized. Message: Hyponatremic-HypertensiveSyndrome does not always result from unilateral renal artery stenosis. High index of clinicalsuspicion with appropriate imaging technique may clinch rare endocrine causes ofhypertension, like paraganglioma.