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[Primary antiphospholipid syndrome associated with malignant hypertension]
L Ribera1, M Vallvé, J Almirall
1Servicio de Nefrología, Corporació Sanitaria Parc Taulí, Institut Universitari Parc Taulí, Universitat Autónoma de Barcelona, Sabadell.
Summary
Antiphospholipid syndrome can cause rare renal artery thrombosis, leading to malignant hypertension. Prompt treatment with medications like ACE-inhibitors can effectively manage blood pressure in affected patients.
Area of Science:
- Nephrology
- Rheumatology
- Vascular Medicine
Background:
- Antiphospholipid syndrome (APS) is characterized by antiphospholipid antibodies and recurrent thrombosis.
- Renal involvement occurs in 20-25% of APS cases, with renal artery thrombosis being exceptionally rare.
Observation:
- A 39-year-old woman with primary APS presented with malignant hypertension.
- She had a history of recurrent thrombosis, high IgG anticardiolipin antibody titers, and a positive lupus anticoagulant.
- Clinical presentation included asymmetrical kidney function and pre-occlusive left renal artery thrombosis.
Findings:
- The patient's malignant hypertension was directly linked to the renal artery thrombosis.
- Isotopic renogram revealed differential kidney function (60% right, 40% left).
- Renal arteriography confirmed a significant blockage in the left renal artery.
Implications:
- This case highlights the importance of considering renal artery thrombosis in APS patients with unexplained hypertension.
- Early diagnosis and management, including ACE-inhibitors and alpha blockers, are crucial for blood pressure control.
- Further research into the vascular complications of APS is warranted.