Orthostatic hypertension due to coexistence of renal fibromuscular dysplasia and nephroptosis.
A 42-year-old woman presented with orthostatic hypertension. Increased plasma renin activity was noted and blood pressure rose gradually with standing. Selective renal arteriography indicated narrowing of the distal portion of the right renal artery and poststenotic dilatation and signs of arterial stenosis due to fibromuscular dysplasia. Greater arterial narrowing resulted from tortion due to nephroptosis brought about by excessive renin secretion. Thus, both renal arterial stenosis and nephroptosis were considered responsible for the present orthostatic hypertension. Percutaneous transluminal renal angioplasty was found very effective for normalizing standing blood pressure and renal blood flow.
Tsukamoto
Y
Y
Department of Internal Medicine, Kitasato University School of Medicine, Kanagawa, Japan.
Komuro
Y
Y
Akutsu
F
F
Fujii
K
K
Marumo
F
F
Kusano
S
S
Kikawada
R
R
D000328:Adult; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000150:complications*; D001794:Blood Pressure; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D006978:Hypertension, Renovascular / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D007674:Kidney Diseases / Q000150:complications*; D011187:Posture; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging; D012078:Renal Artery Obstruction / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D012079:Renal Circulation