[Unilateral renal artery stenosis. Color-coded Doppler sonography and captopril scintigraphy in a 13-year-old patient].
Modern noninvasive techniques, such as doppler sonography or color-encoded doppler sonography, have only rarely been used for diagnosis of renovascular hypertension in children. In the following case report, we describe the successful diagnosis of renovascular hypertension in a 13-year-old girl by using color-encoded doppler sonography and Captopril renal scintigraphy. The patient was admitted with hypertension of 180/130 mmHg. Laboratory findings showed elevated plasma renin and aldosterone concentrations. No abnormalities were found by abdominal sonography, isotope renography, intravenous pyelography, or in venous digital subtraction angiography. However, subsequent color-encoded doppler sonography clearly showed evidence of an artery stenosis of the right kidney. Furthermore, isotope renography one hour after oral administration of captopril revealed an almost complete loss of glomerular filtration rate of the right kidney. Based on these findings, arterial digital subtraction angiography, including transluminal angioplasty, was performed. During this treatment procedure, the right renal artery stenosis could be confirmed and was subsequently dilated without complication. In the following twelve months the patient remained normotensive and required no further antihypertensive drug treatment.
Melter
M
M
Zentrum Kinderheilkunde und Humangenetik, Medizinischen Hochschule Hannover.
Hoyer
P F
PF
Kotzerke
J
J
Schäfer
C
C
Brodehl
J
J
D015901:Angiography, Digital Subtraction; D001783:Blood Flow Velocity / Q000187:drug effects; D002216:Captopril; D002404:Catheterization; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis* / Q000628:therapy; D012078:Renal Artery Obstruction / Q000175:diagnosis* / Q000628:therapy; D012079:Renal Circulation / Q000187:drug effects; D016284:Technetium Tc 99m Pentetate; D014463:Ultrasonography
D002216:Captopril; D016284:Technetium Tc 99m Pentetate
Einseitige Nierenarterienstenose. Farbkodierte Doppler-Sonographie und Captopril-Szintigraphie bei einer 13jährigen Patientin.