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A case of treatable hypertension: fibromuscular dysplasia of renal arteries

BACKGROUND: Renovascular hypertension accounts for 51–52 % of all cases of hypertension in the general population, but plays a major role in treatable causes for hypertension in the young. This entity consists of renal vascular atherosclerosis (90 %), commonly seen among the elderly population, and...

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Autores principales: Ralapanawa, Dissanayake Mudiyanselage Priyantha Udaya Kumara, Jayawickreme, Kushalee Poornima, Ekanayake, Ekanayake Mudiyanselage Madhushanka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4698323/
https://www.ncbi.nlm.nih.gov/pubmed/26724918
http://dx.doi.org/10.1186/s13104-015-1835-z
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author Ralapanawa, Dissanayake Mudiyanselage Priyantha Udaya Kumara
Jayawickreme, Kushalee Poornima
Ekanayake, Ekanayake Mudiyanselage Madhushanka
author_facet Ralapanawa, Dissanayake Mudiyanselage Priyantha Udaya Kumara
Jayawickreme, Kushalee Poornima
Ekanayake, Ekanayake Mudiyanselage Madhushanka
author_sort Ralapanawa, Dissanayake Mudiyanselage Priyantha Udaya Kumara
collection PubMed
description BACKGROUND: Renovascular hypertension accounts for 51–52 % of all cases of hypertension in the general population, but plays a major role in treatable causes for hypertension in the young. This entity consists of renal vascular atherosclerosis (90 %), commonly seen among the elderly population, and renal fibro muscular dysplasia (FMD) (10 %), predominantly seen in the young. The prevalence of clinically significant renal artery fibromuscular dysplasia is 0.4 %. CASE PRESENTATION: We present a case of treatable young hypertension in a 29 year old female, who was diagnosed with renovascular hypertension due to fibromuscular dysplasia of the left renal artery. Computed tomographic angiogram revealed significant stenosis of the left main renal artery. Diethylene triamine penta acetic acid renogram showed a small left kidney due to renal artery stenosis. She underwent left sided nephrectomy, and histology revealed features of FMD, after which she achieved full recovery with normalization of blood pressure, and did not require antihypertensive drug treatment. CONCLUSIONS: Fibromuscular 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 family history of hypertension. A high index of suspicion is necessary in early diagnosis and prompt treatment, which can result in rapid and complete recovery.
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spelling pubmed-46983232016-01-04 A case of treatable hypertension: fibromuscular dysplasia of renal arteries Ralapanawa, Dissanayake Mudiyanselage Priyantha Udaya Kumara Jayawickreme, Kushalee Poornima Ekanayake, Ekanayake Mudiyanselage Madhushanka BMC Res Notes Case Report BACKGROUND: Renovascular hypertension accounts for 51–52 % of all cases of hypertension in the general population, but plays a major role in treatable causes for hypertension in the young. This entity consists of renal vascular atherosclerosis (90 %), commonly seen among the elderly population, and renal fibro muscular dysplasia (FMD) (10 %), predominantly seen in the young. The prevalence of clinically significant renal artery fibromuscular dysplasia is 0.4 %. CASE PRESENTATION: We present a case of treatable young hypertension in a 29 year old female, who was diagnosed with renovascular hypertension due to fibromuscular dysplasia of the left renal artery. Computed tomographic angiogram revealed significant stenosis of the left main renal artery. Diethylene triamine penta acetic acid renogram showed a small left kidney due to renal artery stenosis. She underwent left sided nephrectomy, and histology revealed features of FMD, after which she achieved full recovery with normalization of blood pressure, and did not require antihypertensive drug treatment. CONCLUSIONS: Fibromuscular 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 family history of hypertension. A high index of suspicion is necessary in early diagnosis and prompt treatment, which can result in rapid and complete recovery. BioMed Central 2016-01-02 /pmc/articles/PMC4698323/ /pubmed/26724918 http://dx.doi.org/10.1186/s13104-015-1835-z Text en © Ralapanawa et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Ralapanawa, Dissanayake Mudiyanselage Priyantha Udaya Kumara
Jayawickreme, Kushalee Poornima
Ekanayake, Ekanayake Mudiyanselage Madhushanka
A case of treatable hypertension: fibromuscular dysplasia of renal arteries
title A case of treatable hypertension: fibromuscular dysplasia of renal arteries
title_full A case of treatable hypertension: fibromuscular dysplasia of renal arteries
title_fullStr A case of treatable hypertension: fibromuscular dysplasia of renal arteries
title_full_unstemmed A case of treatable hypertension: fibromuscular dysplasia of renal arteries
title_short A case of treatable hypertension: fibromuscular dysplasia of renal arteries
title_sort case of treatable hypertension: fibromuscular dysplasia of renal arteries
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4698323/
https://www.ncbi.nlm.nih.gov/pubmed/26724918
http://dx.doi.org/10.1186/s13104-015-1835-z
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