A Case Report of Thrombotic Microangiopathic Malignant Hypertension

Taner Basturk,Özgül Pamukcu

doi:10.4172/2167-1095.1000205

Abstract

We represented a case of malignant hypertension with thrombotic microangiopathy. There was found no finding revealing renovascular hypertension inspite of high renin and aldosterone levels. The patient responded to aldactone that was administered because of the likelihood of primary aldosteronism regarding the causes of secondary hypertension. We aimed to point out that the laboratory tests may reflect the outcomes of microangiopathic hemolytic anemia; therefore in such circumstances it may be impossible to find out the main reason of hypertension

Highlights

In conditions such as hemolytic uremic syndrome, disseminated intravascular coagulation, thrombotic thrombocytopenic purpura and malignant hypertension, the endothelial layer of small vessels is damaged by fibrin deposition and platelet aggregation
Malignant hypertension is a condition characterized by severe hypertension and acute ischemic complications and it is frequently complicated by a thrombotic microangiopathy (TMA)
This form of AKI may require months of dialysis before the time to recovering renal blood flow allows a return to supportive treatment [3]. In this case we aimed to point out that the laboratory tests may be influenced by the outcomes of microangiopathic hemolytic process and sometimes it may be impossible to clarify the main reason of hypertension

Summary

Introduction

In conditions such as hemolytic uremic syndrome, disseminated intravascular coagulation, thrombotic thrombocytopenic purpura and malignant hypertension, the endothelial layer of small vessels is damaged by fibrin deposition and platelet aggregation. TMA can be complicated by AKI despite absence of irreversible lesions of the renal tissue and this functional renal insufficiency is due to an intense renal vasoconstriction with an arrest of the circulation to the cortex This form of AKI may require months of dialysis before the time to recovering renal blood flow allows a return to supportive treatment [3]. A 29 year old man has referred to our nephrology outpatient clinic with high urea and creatinine levels after the diagnosis of hypertension 3 months ago by the physician who examined the patient with the complaints of new onset headache, nausea and vomiting. He is a 20 package – year smoker. J Hypertens (Los Angel) 4: 205. doi:10.4172/2167-1095.1000205 is under control with spironolactone 100 mg a day and there is no abnormality on potassium, LDH and hemoglobin levels one month after discharge (Figure 1)

Discussion

Findings

Conclusion