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Catastrophic Fibromuscular Dysplasia Presenting with Concomitant Bilateral Renal Infarction, Vertebral Artery

Nicholas Martin Gourd1, Hannah Elizabeth Jenkins1, Richard Miles1

  • 1Renal Department, University Hospitals Plymouth, Plymouth, UK.

Case Reports in Nephrology and Dialysis
|January 19, 2023
PubMed

Insights

Fibromuscular dysplasia (FMD) can present unusually, causing severe issues like kidney infarction and artery dissections. Early FMD diagnosis is crucial for effective management and treatment, even in seemingly healthy individuals.

Area of Science:

  • Vascular Medicine
  • Arterial Disorders
  • Case Reports

Background:

  • Fibromuscular dysplasia (FMD) is a non-atherosclerotic, non-inflammatory arterial disease.
  • It affects the muscular layer of artery walls, potentially causing stenosis, occlusion, and dissection.
  • FMD's varied presentations can complicate diagnosis.

Observation:

  • This case report details an unprecedented FMD presentation in a 37-year-old female.
  • The patient experienced bilateral renal infarction, sequential vertebral artery dissections, and mesenteric ischemia.
  • She required ongoing renal replacement therapy.

Findings:

  • The unusual FMD manifestation masked the underlying diagnosis.
  • Fibromuscular dysplasia can present with a wide spectrum of severe vascular complications.
  • This case underscores the diagnostic challenges posed by atypical FMD.

Implications:

  • Early consideration of FMD in differential diagnoses is vital.
  • Prompt diagnosis guides effective management strategies, including imaging and multidisciplinary care.
  • Recognizing unusual FMD presentations improves patient outcomes and treatment planning.
Keywords:
Acute kidney injuryFibromuscular dysplasiaRenal infarctionVertebral artery dissection

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