SECONDARY ARTERIAL HYPERTENSION: A CASE REPORT OF FIBROMUSCULAR DYSPLASIA
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , |
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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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 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.58043/rphrc.28 https://doi.org/10.58043/rphrc.28 |
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https://doi.org/10.58043/rphrc.28 |
dc.language.iso.fl_str_mv |
por |
language |
por |
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 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
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 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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