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Báo cáo y học: "Fibromuscular dysplasia presenting as a renal infarction: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Fibromuscular dysplasia presenting as a renal infarction: a case report. | Van den Driessche et al. Journal of Medical Case Reports 2010 4 199 http www.jmedicalcasereports.eom content 4 1 199 JOURNALOF.MEDICAL CASE REPORTS CASE REPORT Open Access Fibromuscular dysplasia presenting as a renal infarction a case report AnneliesVan den Driessche 1 Erik Van Hul2 Malika Ichiche1 Gert A Verpooten1 3 and Jean-Louis Bosmans 1 3 Abstract Introduction 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. 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. Conclusions Fibromuscular 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 antihypertensive drugs. Therefore hypertension secondary to fibromuscular dysplasia is the most common cause of curable hypertension. Introduction Fibromuscular dysplasia FMD describes a group of conditions which cause non-atheromatous arterial stenoses most commonly of the renal and internal carotid arteries. FMD is mostly seen in young women. It typically presents with hypertension but presentation with renal infarction has been described in a handful of cases. The clinical presentation of renal infarction includes loin pain and fever. There may be diagnostic delay before diagnosis is made. We .