Fibromuscular dysplasia: Rare case of secondary hypertension in young male

Abstract

Introductionand importance: Renovascular hypertension accounts for 1–2% of all cases of hypertension in the general population, but plays a major role in treatable causes of hypertension in the young. Most of the renovascular diseases are due to atherosclerosis, and fibromuscular disease is thought to be a rare cause of renovascular hypertension. Case presentationWe present a rare case of a young male patient who was diagnosed with renovascular hypertension due to fibromuscular dysplasia of both renal arteries. Computed tomographic angiogram revealed thinning and narrowing area of both renal arteries The left kidney looks atrophied. After vigorous antihypertensive medication and hemodialysis, he was discharged with normal blood pressure without the need for angioplasty. Clinical discussionFibromuscular dysplasia (FMD) is a nonatherosclerotic, noninflammatory arterial disease that most commonly involves the renal and carotid arteries. Renal arteries are most commonly involved. Renal FMD may lead to renal failure and secondary hypertension. Multiple stenoses and the ‘string-of-beads' appearance seen in renal angiogram are diagnostic for FMD. Females are mostly affected by FMD. Our case was a successfully managed young male patient with renal failure and resistant hypertension due to renal FMD. ConclusionsFibromuscular dysplasia causing renal artery stenosis, though a rare cause of renovascular hypertension, is essential to be considered in young hypertensives, even in the absence of a family history of hypertension. A high index of suspicion is necessary for early diagnosis and prompt treatment, which can result in rapid and complete recovery.