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Unilateral Renal Artery Stenosis Associated with Severe Hypertension: Atypical Presentation of Tuberculosis

Netsanet Workneh Gidi1, Workineh Tesfaye1, Mohammed Beshir1

  • 1Department of Pediatrics and Child Health, Jimma University, Jimma, Ethiopia.

Ethiopian Journal of Health Sciences
|October 27, 2021
PubMed

Insights

Tuberculosis (TB) can cause rare infectious renal artery stenosis in children, leading to severe hypertension. Early diagnosis and preventive therapy are crucial to avoid serious complications like stroke and malnutrition.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Cardiology

Background:

  • Renal artery stenosis is a frequent cause of pediatric hypertension.
  • Infectious etiologies of renal artery stenosis are uncommon.
  • Diagnosing tuberculosis (TB) in children presents significant challenges, often leading to delayed identification.

Observation:

  • A 4-year-old girl presented with loss of consciousness and seizures.
  • She had severe acute malnutrition, TB symptoms, and contact with smear-positive TB adults.
  • Her blood pressure was recorded at 200/140 mmHg.

Findings:

  • The patient was diagnosed with disseminated TB, left renal artery stenosis, severe hypertension, cardiomegaly, upper gastrointestinal bleeding, stroke, and severe malnutrition.
  • Diagnosis was confirmed via head CT scan, MRI, and renal ultrasound.
  • While antituberculosis drugs and supportive care resolved most symptoms, hypertension persisted, requiring surgical intervention for renal stenosis.

Implications:

  • Atypical presentations of TB necessitate consideration, particularly with a history of close contact.
  • Timely tuberculosis preventive therapy could have potentially averted the severe complications observed in this case.
Abstract

Keywords:
Tuberculosishypertension in childrenrenal artery stenosis

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