Fibromuscular Dysplasia of the Renal Artery and Pseudoephedrine Use: Coincidence Or Cause?

Abstract

Pseudoephedrine is an alpha agonist that increases smooth muscle tone in various organs. The increasing popularity of this medication results from its decongestion effect on mucous membranes. Pseudoephedrine, in conjunction with antihistamines, is found in over-the-counter pharmaceuticals for treatment of the common cold and allergic rhinitis. Though the vasoconstrictive effect of pseudoephredrine on the renal artery is well known, fibromuscular dysplasia, an arteriopathy of unknown cause, associated with chronic pseudoephedrine use has not been previously recognized. In this paper, I report a case of fibromuscular dysplasia in a patient who had used neosynephrine nasal solution twice daily for at least ten years. Perhaps further observations in the future will define whether the association is causal or accidental.