Differential Diagnosis for a 16-year-old girl with elevated blood pressure, headache, upper respiratory tract infection, and overweight

• Single most likely diagnosis:
  • Essential Hypertension: This is the most common cause of hypertension in adolescents, especially when combined with being overweight. The presence of an upper respiratory tract infection could be coincidental, and the headache might be related to the hypertension or the infection.
• Other Likely diagnoses:
  • White Coat Hypertension: The elevated blood pressure reading could be due to anxiety or stress in a clinical setting, which is common in adolescents.
  • Secondary Hypertension due to Renal Disease: Conditions like chronic kidney disease or renal vascular hypertension could present with hypertension and might be associated with other systemic symptoms.
  • Sleep Apnea: Given the patient's overweight status, sleep apnea is a possible cause of secondary hypertension, and it could also contribute to headaches.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
  • Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic or sustained hypertension, headaches, and other systemic symptoms. Although rare, it's critical to consider due to its potential severity.
  • Hyperthyroidism: Can cause hypertension, weight loss (despite increased appetite), and other systemic symptoms. It's less likely given the patient is overweight, but it's a condition that should not be missed.
  • Coarctation of the Aorta: A congenital condition that can lead to hypertension, especially in younger patients. It might not directly cause an upper respiratory tract infection but is crucial to diagnose due to its implications for cardiovascular health.
• Rare diagnoses:
  • Cushing's Syndrome: A rare endocrine disorder that can cause hypertension, weight gain (particularly in the central part of the body), and other symptoms. It's less likely but should be considered in the differential diagnosis due to its significant health implications.
  • Hyperparathyroidism: Can lead to hypertension and might be associated with other systemic symptoms, though it's rare in adolescents.
  • Glucocorticoid-remediable Aldosteronism: A rare genetic disorder causing hypertension due to excessive aldosterone production. It's an important consideration in young patients with hypertension, despite its rarity.