Abstract
IntroductionFibromuscular dysplasia is a non-atherosclerotic, non-inflammatory disease that most commonly affects the renal and internal carotid arteries.Case presentationWe present the case of a 44-year-old Caucasian man who was admitted with complaints of loin pain and hypertension. A computed tomography scan of the abdomen revealed a right renal infarction with a nodular aspect of the right renal artery. Subsequent renal angiography revealed a typical 'string of beads' pattern of the right renal artery with thrombus formation. Oral anticoagulation was started and the secondary hypertension was easily controlled with anti-hypertensive drugs. At follow-up, our patient refused percutaneous transluminal renal angioplasty as a definitive treatment.ConclusionsFibromuscular dysplasia is the most common cause of renovascular hypertension in patients under 50 years of age. Presentation with renal infarction is rare.In fibromuscular dysplasia, angioplasty has been proven to have, at least for some indications, an advantage over anti-hypertensive drugs. Therefore, hypertension secondary to fibromuscular dysplasia is the most common cause of curable hypertension.
Highlights
Fibromuscular dysplasia is a non-atherosclerotic, non-inflammatory disease that most commonly affects the renal and internal carotid arteries.Case presentation: We present the case of a 44-year-old Caucasian man who was admitted with complaints of loin pain and hypertension
It typically presents with hypertension, but presentation with renal infarction has been described in a handful of cases
We report the case of Fibromuscular dysplasia (FMD) presenting with unilateral renal infarction
Summary
We presented a case of renal infarction complicating FMD. This rare combination has only been described in a handful of cases [21,22]. Blood pressure was controlled by two classes of oral anti-hypertensive agents. A redo-angiography has to be performed, as it is important to control if thrombus has resolved. AVDD, MI, GV and JLB all contributed to clinical diagnosis and work-up. Author Details 1Department of Nephrology-Hypertension, Antwerp University Hospital, Edegem (Antwerpen), Belgium, 2Department of Radiology, Antwerp University Hospital, Edegem (Antwerpen), Belgium and 3Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Belgium.
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