Unusual case of renal artery stenosis, what is the diagnosis

Özet

Renal vaküler hastalık hipertansiyon ve böbrek yetmezliğinin düzeltilebilir nadir bir sebebidir. En önemli 2 sebebi ateroskeleroz (%70) ve fibromüsküler displazidir (%25). Bizim bu olgumuz ateroskleroz risk faktörleri olmayan, ani başlangıçtı kontrolsüz hipertansiyonu olan genç bayandı. Hastamızın sağ renal arter orta bölgede fokal darlığı mevcuttu ve karakteristik anjiyografik fibromüsküler displazi bulguları yoktu. Nadir görülen bir fokal fibromüsküler displazi mi yoksa aterosklerotik lezyonmu ayırımı yapamadık. Hastamızı perkutan koroner stent kullanarak başarılı bir şekilde tedavi ettik. Hastamızın hipertansiyonu düzeldi. Biz diğer uzmanların tanı ve tedavi ile ilgili düşüncelerini merak ediyoruz?

Abstract

Renal vascular disease, although rare, is one of the more common and potentially reversible and curable cause of hypertension and renal dysfunction. The two most common causes of renal vascular disease is atherosclerosis (%70) and fibromuscular dysplasia (%25). We reported an unusual case of a young woman presented with abrupt onset, poorly controlled hypertension without any other atherosclerosis risk factors, was associated with stenosis in the middle of the right renal artery. This stenosis was not consistent with characteristic form of fibromuscular dysplasia on angiography. We could not differentiate this stenosis was caused by either a focal fibromuscular dysplasia or an unusual atherosclerotic disease. We treated successfully by direct percutaneous coronary stent implantation with no complication. She had relief of hypertension. But we are interest in other authors what are thinking of about this renal artery stenosis was caused by which. What is the correct diagnosis? Is the treatment of choice true?