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Unique imaging findings in fibromuscular dysplasia of renal arteries: A case report

RATIONALE: Fibromuscular dysplasia (FMD) is a rare vascular disorder that causes abnormal cell growth in arterial walls. The classic “string of beads” sign has been reported in many cases, whereas the appearance of tubular stenosis and distal tapering of renal arteries with multiple renal infarction...

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Autores principales: Kong, Weiying, Hu, Zhangxue
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257553/
https://www.ncbi.nlm.nih.gov/pubmed/30431564
http://dx.doi.org/10.1097/MD.0000000000012815
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author Kong, Weiying
Hu, Zhangxue
author_facet Kong, Weiying
Hu, Zhangxue
author_sort Kong, Weiying
collection PubMed
description RATIONALE: Fibromuscular dysplasia (FMD) is a rare vascular disorder that causes abnormal cell growth in arterial walls. The classic “string of beads” sign has been reported in many cases, whereas the appearance of tubular stenosis and distal tapering of renal arteries with multiple renal infarctions, as well as left kidney atrophy occurring in one patient, has not been precisely described. PATIENT CONCERNS: A 19-year-old woman presented to us with a history of elevated blood pressure without any symptoms for the past 1 month. Routine laboratory tests indicated a moderately impaired renal function, and ultrasound examination demonstrated a small-sized left kidney and seriously decreased blood flow of the left renal artery and its branches. DIAGNOSIS: Subsequent contrast-enhanced computed tomographic angiography (CTA) demonstrated multiple ischemic infarctions in the bilateral kidneys, and FMD was suggested at that time. Thereafter, we performed selective reno-angiography, which confirmed that the all left renal arteries had tubular stenosis and that right renal arterial branches presented distal tapering. INTERVENTION: Antihypertensive drugs were prescribed conservatively, including nifedipine 60 mg/d and prazosin 4 mg/d, to lower the patient's blood pressure. OUTCOMES: The patient had a well-controlled blood pressure and an improved renal function at her 6-month follow-up. LESSONS: We should take the diagnosis of FMD into account if young women develop asymptomatic hypertension. To our knowledge, this is the first case that exhibited renal artery FMD manifesting as tubular stenosis and distal tapering, especially followed by bilateral renal infarctions and significant atrophy of the left kidney. In addition, CTA combined with digital subtraction angiography (DSA) may be more sensitive than other tests with respect to the detection of intrarenal infarctions and arterial variants of FMD.
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spelling pubmed-62575532018-12-17 Unique imaging findings in fibromuscular dysplasia of renal arteries: A case report Kong, Weiying Hu, Zhangxue Medicine (Baltimore) Research Article RATIONALE: Fibromuscular dysplasia (FMD) is a rare vascular disorder that causes abnormal cell growth in arterial walls. The classic “string of beads” sign has been reported in many cases, whereas the appearance of tubular stenosis and distal tapering of renal arteries with multiple renal infarctions, as well as left kidney atrophy occurring in one patient, has not been precisely described. PATIENT CONCERNS: A 19-year-old woman presented to us with a history of elevated blood pressure without any symptoms for the past 1 month. Routine laboratory tests indicated a moderately impaired renal function, and ultrasound examination demonstrated a small-sized left kidney and seriously decreased blood flow of the left renal artery and its branches. DIAGNOSIS: Subsequent contrast-enhanced computed tomographic angiography (CTA) demonstrated multiple ischemic infarctions in the bilateral kidneys, and FMD was suggested at that time. Thereafter, we performed selective reno-angiography, which confirmed that the all left renal arteries had tubular stenosis and that right renal arterial branches presented distal tapering. INTERVENTION: Antihypertensive drugs were prescribed conservatively, including nifedipine 60 mg/d and prazosin 4 mg/d, to lower the patient's blood pressure. OUTCOMES: The patient had a well-controlled blood pressure and an improved renal function at her 6-month follow-up. LESSONS: We should take the diagnosis of FMD into account if young women develop asymptomatic hypertension. To our knowledge, this is the first case that exhibited renal artery FMD manifesting as tubular stenosis and distal tapering, especially followed by bilateral renal infarctions and significant atrophy of the left kidney. In addition, CTA combined with digital subtraction angiography (DSA) may be more sensitive than other tests with respect to the detection of intrarenal infarctions and arterial variants of FMD. Wolters Kluwer Health 2018-11-16 /pmc/articles/PMC6257553/ /pubmed/30431564 http://dx.doi.org/10.1097/MD.0000000000012815 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle Research Article
Kong, Weiying
Hu, Zhangxue
Unique imaging findings in fibromuscular dysplasia of renal arteries: A case report
title Unique imaging findings in fibromuscular dysplasia of renal arteries: A case report
title_full Unique imaging findings in fibromuscular dysplasia of renal arteries: A case report
title_fullStr Unique imaging findings in fibromuscular dysplasia of renal arteries: A case report
title_full_unstemmed Unique imaging findings in fibromuscular dysplasia of renal arteries: A case report
title_short Unique imaging findings in fibromuscular dysplasia of renal arteries: A case report
title_sort unique imaging findings in fibromuscular dysplasia of renal arteries: a case report
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257553/
https://www.ncbi.nlm.nih.gov/pubmed/30431564
http://dx.doi.org/10.1097/MD.0000000000012815
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