[A difficult diagnostic case of malignant hypertension]

A case of a 62-year old male with malignant hypertension was described. The clinical picture was dominated by the presence of cachexia, polyuria and polyneuropathy. Laboratory examinations revealed highly elevated sedimentation rate, hyponatremia and hypokalemia. Secondary hypertension as well as other diseases with similar clinical symptoms were excluded basing in diagnostic procedures. The authors discuss pathophysiological mechanisms on the base of abnormally elevated activity of the renin-angiotensin-aldosterone system. Unusual body weight loss (approximately 20 kgs), polyneuropathy and irreversible lesion of renal tubules without renal function impairment are emphasized.