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Diagnostic problems in renal hypertension. A case report

M Sandler, L H Opie

    South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
    |July 31, 1982
    PubMed
    Summary

    Severe hypertension in a young woman was caused by fibromuscular dysplasia of the renal artery. A diagnostic guideline for young adults with drug-resistant hypertension is proposed.

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    Area of Science:

    • Nephrology
    • Vascular Biology
    • Cardiology

    Background:

    • Fibromuscular dysplasia (FMD) is a non-atherosclerotic, non-inflammatory condition affecting arterial walls.
    • Renal artery stenosis due to FMD is a recognized cause of secondary severe hypertension.
    • Diagnosis and management can be challenging, particularly in atypical presentations.

    Observation:

    • A young adult woman presented with severe, drug-resistant hypertension.
    • Atypical clinical and biochemical features were noted.
    • Imaging revealed fibromuscular dysplasia of the renal artery.

    Findings:

    • Confirmed fibromuscular dysplasia as the cause of severe hypertension.
    • Identified several atypical clinical and biochemical markers associated with this case.
    • Demonstrated the importance of considering FMD in young adults with resistant hypertension.

    Implications:

    • Suggests a diagnostic guideline for investigating severe hypertension in young adults unresponsive to medication.
    • Highlights the need for increased awareness of FMD, especially in atypical presentations.
    • Contributes to understanding the diverse manifestations of fibromuscular dysplasia in arterial vessels.

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