Reversible hypertension and infective arteritis

Abstract

Background: Idiopathic vasculitides or arteritis have very few or none treatment options. Identification of infective arteritis based on high clinical suspicion opens a window for treatment of such cases . Although these are occasional clinical scenario. Aims and Objectives: To identify the treatable cause of arteritis and starting initial treatment based on clinical suspicion. Material and Methods: Based on high clinical suspicion we aim to identify chronic infective cause of arteritis among patients of SS Hospital from 2019 to 2020 coming in EOPD. Results and Discussion: Three cases of reversible hypertension from different clinical setup relating to a common infective etiology, i.e., tuberculosis identified during the said duration, all cases presented with constitutional symptoms for 2–6 months with headache, loss of appetite, fever, and malaise. The first case presented as acute abdomen in EOPD having mesenteric ischemia and hypertension. The second case presented in antenatal care OPD with hypertension which was nonrelated to pregnancy. The third case presented in medicine OPD as a case of young hypertensive without mood changes. Partial renal artery stenosis relating to infective arteritis was a common finding in all cases. All cases responded well with the firstline antitubercular medication and became normotensive (without medication) in the follow up. Conclusion: The cause of renal artery stenosis appeared to be related to tubercular arteritis of vessel with either a past history of pulmonary TB or TB contact. Renovascular tubercular arteritis has been defined in only a few literatures and only handful of cases being reported making worth presentation.