SECONDARY ARTERIAL HYPERTENSION: A CASE REPORT OF FIBROMUSCULAR DYSPLASIA

Detalhes bibliográficos
Autor(a) principal: Freitas, Andreia
Data de Publicação: 2022
Outros Autores: Paixão Dias, Vitor, Mendonça Pinheiro, Dulce
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.58043/rphrc.28
Resumo: Fibromuscular dysplasia (FMD) is an idiopathic, non-inflammatory, non-atherosclerotic systemic disease characterized by stenosis, occlusion, aneurysm, dissection and tortuosity of arterial beds. Arterial hypertension (HTN) is the most common manifestation of FMD of renal arteries.This article describes a clinical case suggestive of FMD as cause of secondary hypertension – a 47-year-old woman with long-term and difficult-to-control HTN, with multiple end-organ damage and history of acute kidney injury associated with the introduction of Valsartan; analytically, the patient had increased plasma aldosterone/renin ratio (32.5:1) and imagiologically reduction of the caliber of renal arteries and celiac trunk, ischemia of the left kidney and aneurysms of the pancreatic-duodenal, lumbar and cerebral arteries was observed. The diagnosis of FMD is based on clinical evaluation and imaging tests (renal arteriography is the gold-standard, but non-invasive tests are considered reasonable alternatives). Treatment includes medical therapy, and revascularization (angioplasty or surgery) may be considered if the benefits outweigh the risks of the procedure.
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spelling SECONDARY ARTERIAL HYPERTENSION: A CASE REPORT OF FIBROMUSCULAR DYSPLASIAHIPERTENSÃO ARTERIAL SECUNDÁRIA: UM CASO DE DISPLASIA FIBROMUSCULARFibromuscular dysplasia (FMD) is an idiopathic, non-inflammatory, non-atherosclerotic systemic disease characterized by stenosis, occlusion, aneurysm, dissection and tortuosity of arterial beds. Arterial hypertension (HTN) is the most common manifestation of FMD of renal arteries.This article describes a clinical case suggestive of FMD as cause of secondary hypertension – a 47-year-old woman with long-term and difficult-to-control HTN, with multiple end-organ damage and history of acute kidney injury associated with the introduction of Valsartan; analytically, the patient had increased plasma aldosterone/renin ratio (32.5:1) and imagiologically reduction of the caliber of renal arteries and celiac trunk, ischemia of the left kidney and aneurysms of the pancreatic-duodenal, lumbar and cerebral arteries was observed. The diagnosis of FMD is based on clinical evaluation and imaging tests (renal arteriography is the gold-standard, but non-invasive tests are considered reasonable alternatives). Treatment includes medical therapy, and revascularization (angioplasty or surgery) may be considered if the benefits outweigh the risks of the procedure.A displasia fibromuscular (DFM) é uma doença sistémica idiopática, não-inflamatória, não-aterosclerótica caracterizada por estenose, oclusão, aneurisma, disseção e tortuosidade arteriais. A hipertensão arterial (HTA) é a manifestação mais comum de DFM das artérias renais.Neste artigo descreve-se um caso sugestivo de DFM como causa de HTA secundária – uma mulher de 47 anos com HTA de longa data e de difícil controlo, com atingimento de múltiplos órgãos-alvo e história de lesão renal aguda associada à introdução de Valsartan; analiticamente a doente apresentava razão aldosterona/renina plasmáticas aumentada (32.5:1) e imagiologicamente foi objetivada redução do calibre das artérias renais e tronco celíaco, isquemia do rim esquerdo e aneurismas das artérias pancreático-duodenal inferior, lombares e da artéria cerebral média esquerda. O diagnóstico de DFM assenta nas avaliações clínica e imagiológica (a arteriografia renal é o gold-standard, mas testes não-invasivos são considerados alternativas aceitáveis). O tratamento inclui terapêutica médica, e a revascularização (angioplastia ou cirurgia) pode ser considerada se os benefícios superarem os riscos associados ao procedimento.Revista Portuguesa de Hipertensão e Risco Cardiovascular2022-06-04info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.58043/rphrc.28https://doi.org/10.58043/rphrc.28Revista Portuguesa de Hipertensão e Risco Cardiovascular; N.º 83 (2021): Maio / Junho ; 19-221646-8287reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revistahipertensao.pt/index.php/rh/article/view/28https://revistahipertensao.pt/index.php/rh/article/view/28/31Direitos de Autor (c) 2022 Revista Portuguesa de Hipertensão e Risco Cardiovascularinfo:eu-repo/semantics/openAccessFreitas, AndreiaPaixão Dias, VitorMendonça Pinheiro, Dulce2024-02-03T07:36:31Zoai:ojs.revistahipertensao.pt:article/28Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:05:08.084417Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv SECONDARY ARTERIAL HYPERTENSION: A CASE REPORT OF FIBROMUSCULAR DYSPLASIA
HIPERTENSÃO ARTERIAL SECUNDÁRIA: UM CASO DE DISPLASIA FIBROMUSCULAR
title SECONDARY ARTERIAL HYPERTENSION: A CASE REPORT OF FIBROMUSCULAR DYSPLASIA
spellingShingle SECONDARY ARTERIAL HYPERTENSION: A CASE REPORT OF FIBROMUSCULAR DYSPLASIA
Freitas, Andreia
title_short SECONDARY ARTERIAL HYPERTENSION: A CASE REPORT OF FIBROMUSCULAR DYSPLASIA
title_full SECONDARY ARTERIAL HYPERTENSION: A CASE REPORT OF FIBROMUSCULAR DYSPLASIA
title_fullStr SECONDARY ARTERIAL HYPERTENSION: A CASE REPORT OF FIBROMUSCULAR DYSPLASIA
title_full_unstemmed SECONDARY ARTERIAL HYPERTENSION: A CASE REPORT OF FIBROMUSCULAR DYSPLASIA
title_sort SECONDARY ARTERIAL HYPERTENSION: A CASE REPORT OF FIBROMUSCULAR DYSPLASIA
author Freitas, Andreia
author_facet Freitas, Andreia
Paixão Dias, Vitor
Mendonça Pinheiro, Dulce
author_role author
author2 Paixão Dias, Vitor
Mendonça Pinheiro, Dulce
author2_role author
author
dc.contributor.author.fl_str_mv Freitas, Andreia
Paixão Dias, Vitor
Mendonça Pinheiro, Dulce
description Fibromuscular dysplasia (FMD) is an idiopathic, non-inflammatory, non-atherosclerotic systemic disease characterized by stenosis, occlusion, aneurysm, dissection and tortuosity of arterial beds. Arterial hypertension (HTN) is the most common manifestation of FMD of renal arteries.This article describes a clinical case suggestive of FMD as cause of secondary hypertension – a 47-year-old woman with long-term and difficult-to-control HTN, with multiple end-organ damage and history of acute kidney injury associated with the introduction of Valsartan; analytically, the patient had increased plasma aldosterone/renin ratio (32.5:1) and imagiologically reduction of the caliber of renal arteries and celiac trunk, ischemia of the left kidney and aneurysms of the pancreatic-duodenal, lumbar and cerebral arteries was observed. The diagnosis of FMD is based on clinical evaluation and imaging tests (renal arteriography is the gold-standard, but non-invasive tests are considered reasonable alternatives). Treatment includes medical therapy, and revascularization (angioplasty or surgery) may be considered if the benefits outweigh the risks of the procedure.
publishDate 2022
dc.date.none.fl_str_mv 2022-06-04
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dc.relation.none.fl_str_mv https://revistahipertensao.pt/index.php/rh/article/view/28
https://revistahipertensao.pt/index.php/rh/article/view/28/31
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2022 Revista Portuguesa de Hipertensão e Risco Cardiovascular
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2022 Revista Portuguesa de Hipertensão e Risco Cardiovascular
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dc.publisher.none.fl_str_mv Revista Portuguesa de Hipertensão e Risco Cardiovascular
publisher.none.fl_str_mv Revista Portuguesa de Hipertensão e Risco Cardiovascular
dc.source.none.fl_str_mv Revista Portuguesa de Hipertensão e Risco Cardiovascular; N.º 83 (2021): Maio / Junho ; 19-22
1646-8287
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